Impaired Verbal Communication - Nursing Care Plan for Tongue Cancer


Tongue carcinoma is a tumor that occurs bottom of the mouth, sometimes extending towards the tongue and the tongue leads to impaired mobility (Van de Velde, 1999). Tongue cancer (2/3 anterior). Most (40%) of the oral cavity cancer is tongue cancer. The most frequent tumor sites were the lateral edge of the border between the middle of the third back of the tongue.

Tongue cancer is a malignant neoplasm arising from epithelial tissue of the tongue mucosa with cell-shaped "squamous cell carcinoma" (cell stratified squamous epithelium), as well as some specific diseases (premalignant). This cancer can infiltrate into the surrounding area, besides that can be limfogen and hematogenous metastases.

Oral cavity cancers have multifactorial causes and a process consisting of several steps involving initiation, promotion and progression of tumors. Broadly speaking, the etiology of cancer of the tongue:
  1. Tobacco: 80% of patients with tongue cancer were smokers. Risk smokers are 5-9 times more likely than nonsmokers.
  2. Alcoholism: heavy drinkers have a 30 times greater risk and synergistic effect with smoking.
  3. Viral infections in the oral cavity: Human papilloma virus (HPV), especially HPV 16 and HPV 18.
  4. Poor oral hygiene.
  5. Sunburn: irritation sunlight and other chronic irritation.
  6. Lifestyle: the habit of chewing betel.

Clinical manifestations
  1. The early signs are generally a painless ulcer that does not heal. Then enlarged and compress or infiltrate the surrounding tissues resulting in local pain, ipsilateral otalgia and mandibular pain (Suyanto, 2010).
  2. Infiltration into these muscles resulted in limited movement of the tongue so that the bolus ingestion of food and speech impaired. This cancer can infiltrate surrounding tissues such as the floor of the mouth (floor of mouth, FOM), the base of the tongue and tonsils (Suyanto, 2010).
  3. Along with advances in cancer patients may complain of tenderness, difficulty chewing, swallowing, and speaking, cough with sputum or blood faintly enlarged cervical lymph nodes. (Diane C. Baughman, 2000).


Nursing Care Plan for Tongue Cancer


Nursing Diagnosis for Tongue Cancer : Impaired Verbal Communication related to neurological impairment and ability to swallow

Goal: No impairment of verbal communication.

Outcomes: Communication smoothly

Intervention:
1. Assess client communication skills.
R / Knowing the client's communication skills.

2. Provide other means of communication such as a blackboard or a book if the client can not communicate verbally.
R / Assist in communicating.

3. Responsive to bell calls from clients.
R / Keeping the trust of clients.

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