Jumat, 31 Agustus 2012

CANCER naso pharynx


I hope this information useful for my friend ...

 
A. Definition.
Nasopharyngeal cancer is a malignancy that occurs diadaerah nasopharynx. It happened more than half the incidence of all head and neck carcinoma adaerah. High incidence is associated with eating behavior, environment, and epstein-barr virus.

B. Etiology
Nasopharyngeal cancer can be caused by the consumption habits of salted fish or epstein-bar virus infection.
C. Pathophysiology

D. Clinical Manifestations
Sometimes there are only minor complaints such as headache, or hearing about, and often no complaints at all so dileher metastasis is the first sign. Symptoms and signs that may be obtained is dense nasal epistaxis, tinnitus and deafness. Not infrequently patients present with strabismus and bilateral cranial swelling dileher. If the disease has advanced, a complaint can be rinolia, eksoptalmus, and trismus.
On the neck there is a lump cranial medial to the m. sernokleidomastoid the end that eventually form large masses to the skin shiny. Neurologic signs often appear in the form of paresis or paralysis dar nerves III, IV, and VJ (petrosfenoidal syndrome) because these tumors are nerve discharge area as well as other brain sarap base of the skull.
Interruption of nerve IX, X, XI, XII, and the cervical sympathetic nerve called the pharyngeal syndrome. Infiltration of the sympathetic nerves in the neck cause Horner syndrome as miosis, enoftalmus, and ptosis.
Symptoms and signs perceived as the Eustachian tube appendix full feeling in the ear, tinnitus, and hearing loss to deafness.
E. Examination Support.
The diagnosis is established by nasofaringoskopi that also functions untuik biopsimultipel and photos Rongten.
If there are symptoms and signs of suspicious yng be a nasopharyngeal carcinoma, whereas in nasofaringoskopi not visible abnormalities, it is recommended to perform multiple blind biopsies in the nasopharynx ..
F. Handling
Radiotherapy is given in the form of radiation utuk nasofring neck squamous left and right due to the spread trjadi generally bilateral. Prognosis alive after 5 years on the deployment tnkat I sd. IV are respectively 85, 75, 45, and 10%. Approximately one third of patients died of distant metastasis can be found ditulang, lung, and liver. Adjuvant therapy such as chemotherapy can produce a significant improvement for a limited time.

II. NURSING ISSUES AND COLLABORATION
1. Nursing Issues
a. Acute pain b.d damage the tissue (tumor).
b. Impaired sensory perception (hearing) damage bd sensory perception.
c. Anxious bd changes in health status
d. Impaired neuromuscular dysfunction bd ingestion.
2. Collaboration Issues
a. PK: bleeding

Bibliography:
a. Jong et al, 1977, Textbook of Surgery, EGC, Jakarta.
b. Joanne et al, Nursinbg Calsification Intervention, Mosby, USA
c. Swearingen. , 2001. keperawatn Medical Surgery. EGC. Jakarta
d. Nanda. , 2004. Nursing Diagnosis A Guide to Planning Care. Down load from www.Us.Elsevierhealth.

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