Which of the following should be considered the highest priority during the first 24 hours postoperatively for the client who had a total laryngectomy due to cancer of the larynx?
1. Provide adequate nourishment.
2. Prevent skin breakdown.
3. Maintain proper bowel elimination.
4. Maintain a patent airway.
During the first 24 hours after a total laryngectomy, maintaining a patent airway is a priority goal. After a total laryngectomy, the client will have a tracheostomy with increased secretions and will require suctioning and tracheostomy care. Providing adequate nutrition, preventing skin breakdown, and maintaining proper bowel elimination will be appropriate as the client recovers, but maintaining a patent airway is the initial priority goal.
CN: Reduction of risk potential; CL: Synthesize