NUR 634 Topic 3 DQ 1

Discussion: Select one nose, mouth, neck, or throat condition or disorder and complete the following:

NUR 634 Topic 3 DQ 1 Assessment Description

Select one nose, mouth, neck, or throat condition or disorder and complete the following :

Briefly discuss the condition/disorder.

Describe the symptoms and physical exam findings associated with the condition/disorder.

Identify appropriate laboratory, imaging, and other diagnostic/screening tools that apply to the disorder and explain how they will help you with your diagnosis.

List two other conditions that could cause a similar presentation (differential diagnoses) and explain how you would “rule out” those differentials.

Support your description with a minimum of two APRN-approved scholarly resources. You may not select a condition or disorder that has already been profiled by another learner; you must select a different one.

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NUR 634 Topic 3 DQ 1 Sample

Laryngeal squamous cell carcinoma is one of the most common throat condition malignancies associated with tobacco smoking. Prolonged nicotine deposition to the true vocal cords induces a neoplastic oncogenic process, resulting in laryngeal carcinoma (Igissin et al., 2023). Laryngeal carcinoma can be classified based on its location in relation to the true vocal cords into supraglottic, glottis, and subglottic carcinoma. It is crucial to note that concurrent alcohol use has been associated with the development of supraglottic carcinoma.

Patients with laryngeal carcinoma commonly present with hoarseness of voice, dysphagia, odynophagia, and neck swellings. NUR 634 Topic 3 DQ 1 It is crucial to note that in patients with supraglottic carcinoma, dysphagia precedes hoarseness of voice and often presents as a late symptom of the disease. However, in glottis laryngeal carcinoma, hoarseness of voice is an early symptom with dysphagia resulting from spread to supraglottis (Igissin et al., 2023). Additionally, patients with advanced disease may present with weight loss, aspiration, generalized swellings, and airway compromise. Physical examination of the neck lymph nodes may reveal firm, immobile, and painless masses on palpation. Further examination using either direct laryngoscopy or fiberoptic endoscopy may reveal tissue masses developing from the larynx and the extent of spread.

Investigative tests used in laryngeal cancer diagnosis include histologic studies from tissue samples obtained from a fine needle biopsy (FNB) of the swollen nodes. Additionally, a tissue biopsy from direct laryngoscopy or fiberoptic endoscopy is the confirmatory test for the carcinoma (Johnson et al., 2020). NUR 634 Topic 3 DQ 1 After establishing a diagnosis, it is crucial to perform a head and neck computerized tomography (CT) to establish the degree of tumor extension and lymphatic involvement and spread. In advanced disease, a positron emission tomography (PET)-CT is used to determine the extent of distant metastasis.

Chronic laryngitis is a laryngeal inflammatory disease that commonly presents with hoarseness of voice, sore throat, and dysphagia. Direct laryngoscopy can thus differentiate it from laryngeal carcinoma through visualization of the larynx (Johnson et al., 2020). Additionally, secondary lymphatic metastasis of other cancers, such as lung, gastric, and thyroid can also present with swollen cervical lymph nodes similar to laryngeal carcinoma. As a result, PET-CT and nodal FNB are crucial in determining the origin of the cancer.

NUR 634 Topic 3 DQ 1 References

Igissin, N., Zatonskikh, V., Telmanova, Z., Tulebaev, R., & Moore, M. (2023). Laryngeal Cancer: Epidemiology, Etiology, and Prevention: A Narrative Review. Iranian Journal of Public Health, 52(11), 2248-2259. https://doi.org/10.18502/ijph.v52i11.14025

Itamura, K., Hsue, V. B., Barbu, A. M., & Chen, M. M. (2023). Diagnostic Assessment (Imaging) and Staging of Laryngeal Cancer. Otolaryngologic Clinics of North America, 56(2), 215–231. https://doi.org/10.1016/j.otc.2022.12.006

Johnson, D. E., Burtness, B., Leemans, C. R., Lui, V. W., Bauman, J. E., & Grandis, J. R. (2020). Head and neck squamous cell carcinoma. Nature Reviews Disease Primers, 6(1), 1-22. https://doi.org/10.1038/s41572-020-00224-3  NUR 634 Topic 3 DQ 1