Name of Patient: V.F.

Chief Complaints: Left Lateral Neck Mass

Age: 70 years old

Sex: Male

Final Diagnosis: Lateral Neck Mass probably malignant Health Teaching Plan

Medications
Potassium Chloride (Kalium Durule) C- Electrolytes; Principal intracellular cation H- Stabilization of normal potassium levels by means of diagnostic test. Enhanced contraction of muscles thus no muscle weakness and normal renal function E- 10 mEq x 20 cycles IV solution administered as a continuous IV infusion through IVTT C- Caution patient that expanded wax matrix capsules will be found in the stool -Report tingling of the hands or feet, unusual tiredness or weakness, feeling of heaviness in the legs, severe nausea, and vomiting, abdominal pain, black or tarry stools. K- Assess for any history of allergy to tartrazine, aspirin; severe renal impairment;hyperkalemia;

Exercise
Deep breathing exercises- To promote ventilation and reduce air trapping, teach the patient to breathe slowly, prolong expirations to two to three times the duration of inspiration, and to exhale through pursed lips.

Treatment
Chest X-Rays. To visualize the inner structures such as the lungs which patient have a history of TB and is still undergoing further treatment. By the time an x-ray reveals the disease, the patient is well aware of the condition. Furthermore to locate which causation the mass on the neck sprouted from.

Hygiene
Bed bath- to promote cleanliness, to provide comfort and relaxation, to improve the clients self-image, to condition the skin, to stimulate peripheral circulation of the client. Physical CareCleanliness of body, shaving, washing face, nail Trimming, washings of hands Oral care- to maintain the intactness and health of the oral mucosa, to prevent oral infections and promote good oral hygiene thus inhibiting the

Outpatient Referral
Knowing how to feed patient using a nasogastric Tube (NGT)- Tube feedings are given when you cannot eat or drink enough to have adequate nutrition. Good nutrition is needed for your body to heal. Fluid is needed to prevent your body from getting dried out (dehydrated). -When you leave the hospital, you should be able to: Give yourself liquid food and water through the feeding tube o Give yourself medication through the tube o Take care of the tube o Trouble-shot problems if they arise. Important to contact or seek help to your nearest health center if problems occur during administration of NGT.
o

Diet
Nasogastric Tube FeedingSince client is on NGT, comply with the correct food solutions to maintain health through proper nutrition. Osteorized feeding by means of blending foods to soft semi-liquid form by a use of blender, for easy passage of solution in the tube. Advise against excessive hot or cold fluids and foods, which may provoke an irritating abdominal cramps and distention. Important in the diet is maintenance of adequate portions of nutrients and minerals thus some of the sources are: Rich in Protein- adequate protein is required for building skeletal muscle and, repairing tissues. Foods are fish, meat, eggs, soy beans and milk

Flexible nasolaryngoscopy- This out-patient examination procedure is carried out to diagnose To help mobilize conditions of the nose and throat. secretions, teach the A flexible laryngoscope: patient how to cough allows close up view of effectively. If the inaccesible areas of nose and patient with copious throat secretions has the flexible instrument allows us difficulty mobilizing to see around corners secretions, teach his family how to perform the vocal cords can be seen in motion postural drainage and chest physiotherapy. If very bright illumination helps diagnose conditions of the nose, secretions are thick, nasopharynx, larynx and encourage the patient hypopharynx accurately to drink 12 to 15 glasses of fluid per Sputum AFB (Acid Fast Bacilli)day. The acid fast bacteria isolated from the sputum cultures is an Change in position indication of Mycobacterial

Compliance-Instruct the

adynamia episodica hereditaria; acute dehydration; heat cramps, GI disorders that cause delay in passage in the GI tract, cardiac disorders, lactation -Assess the patients skin color, lesions, turgor; injection sites;, baseline ECG; bowel sounds, abdominal examination; urinary output; serum electrolytes, serum bicarbonate -Arrange for serial potassium levels before and during therapy Monitor cardiac rhythm carefully during IV administration Azithromycin (Zithromax) C- semi-synthetic macrolide antibiotic H- Effective against a wide variety of bacteria organisms, such as Hemophilus influenzae, Streptococcus pneumoniae, Mycoplasma pneumoniae, Staphylococcus aureus, and mycobacterium avium, and many others. E-500mg/Tab via Oral OD C- May cause transient abdominal distress, diarrhea, and headache. -Report signs of additional

q2h- Change of position can prevent client in bed rest from developing pressure ulcers

tuberculosis infection. It also gives an indication of whether the infection is in lungs or spread to other regions of the body. Further using this test one can determine the presence of Multi drug Stretching- This is the resistance Tuberculosis slow lengthening of Fine Needle Aspiration and the muscles. Biopsy- is a diagnostic procedure Stretching the arms used to investigate superficial (just and legs before and under the skin) lumps or masses. after exercising helps In this technique, a thin, hollow prepare the muscles needle is inserted into the mass for for activity and helps sampling of cells that, after being prevent injury and muscle strain. Regular stained, will be examined under a microscope. stretching also increases your range Intravenous therapy or IV of motion and therapy-is the giving of liquid flexibility. substances directly into a vein. it is the fastest way to deliver fluids Adequate periods of and medications throughout the bed rest. To regain body. PNSS isotonic solution energy good for replacing fluids in the body. Medications- Drugs such as mention in the first column that were prescribed by the doctor to treat underlying condition.

formation of bacteria in the mouth preventing complications to the growing mass on the neck

client to comply with home medications and maintenance drugs in order to promote and hasten recovery. Suggest rest periods before and after meals if eating produces shortness of breath. Follow up Consultation to monitor the changes of the patients condition.

Rich in CarbohydratesCarbohydrates, also known as starches and sugars, are your body's main energy source. Foods includes anything made with flour or sugar, grains, foods with added sugar, and starchy vegetables such as potatoes and corn

Encourage foods high in potassium include bananas,fruits like orange Exercise.Encourage client to perform regular exercises juice, grape juice, milk, peaches, potatoes, tomatoes. and maintain a healthy Since patient has an lifestyle. abnormal electrolyte Teach good habits of well- imbalance specifically balanced, nutritious intake if potassium. NGT is discontinued. If client has been Quitting Smoking- In order discontinues or weaned from to prevent or slow the NGT, resume a diet as progression of the disease, tolerated with emphasizing smoking cessation is the still on foods that are most essential and yet most nutritious and healthy to eat. commonly overlooked aspect of treatment. Cardiovascular or aerobic: This involves a steady physical activity using large muscle groups. This type of exercise strengthens the heart and

infections (eg, sores in mouth or vagina, vaginal discharge, unresolved fever, severe vomiting, or diarrhea). K- Take all of prescribed medication. Do not discontinue until prescription is completed. -Take suspension 1 hour before or 2 hours after meals; tablet form may be taken with meals to decrease GI effects. -Take suspension 1 hour before or 2 hours after meals; tablet form may be taken with meals to decrease GI effects. Paracetamol C- Antipyretic, analgesic. mild pain or fever H-Reports pain relief and reduction of fever with drug E- 500mg IVTT prn for fever q4h C-Teach patient of drug adverse reaction and to be alert if any are present: -Teach patient that contraindicated to hypersensitive to drug drug is patient

lungs, and improves the body's

-Teach to use drug cautiously if patient has history of chronic

alcohol abuse -Tell patient that long term use of drug can cause liver damage K- Assess patients pain or temperature before and during therapy -Be alert for adverse reaction and drug interaction -Dont use drug if fever higher than 39.5C, last longer than 3 days or recur -Drug is for short terms use contact prescriber if patient takes drug longer than 10 days Albuterol and ipratropium inhaler (Combivent) C-Bronchodilator- For the management of bronchospasm in patients suffering from chronic obstructive pulmonary disease (COPD H-Produces bronchodilation thereby causing relaxation of muscle fibres. E-100/20 mcg per actuation of the inhale, inhalation q6 hours C-Teach patient of drug adverse reaction and to be alert if any are

present: -Teach patient that contraindicated to hypersensitive to drug drug is patient

-Asses patient with cardiac tachyarrhythmias, hypertrophic obstructive cardiomyopathy K-Monitor respiratory status; auscultate lungs before and after inhalation -Report treatment failure (exacerbation of respiratory symptoms) to physician -Allow 30-60 sec between puffs for optimum results. -Wait 5 min between this and other inhaled medications. -Rinse mouth after medication puffs to reduce bitter taste