A patient has been diagnosed with terminal cancer and has decided to not continue with treatment. The nurse would recommend a consult with which healthcare specialty?

A. Dysphagia is a common symptom of esophageal cancer itself, not necessarily a sign of liver metastasis. Dysphagia occurs due to the tumor obstructing the esophagus.

B. Jaundice, characterized by a yellowing of the skin and sclera, can indicate liver dysfunction or metastasis to the liver. When cancer spreads to the liver, it can disrupt its normal functioning, leading to an accumulation of bilirubin in the body, causing jaundice.

C. Vomiting can occur in esophageal cancer due to obstruction or in advanced stages of the disease, but it is not a direct sign of metastasis to the liver.

D. Hypercalcemia can occur in some cancers, but it is not a typical manifestation of liver metastasis from esophageal cancer. It is more commonly seen in cancers such as breast, lung, or multiple myeloma.

A. While mouth rinses can be helpful for some oral conditions, sodium bicarbonate solutions may not be appropriate for all types of oral lesions, and there are other more effective mouth care strategies for managing painful lesions.
B. This is a key intervention for managing painful oral lesions. Regular mouth care helps to maintain oral hygiene, reduce the risk of infection, and decrease discomfort while eating. It also promotes healing and prevents further complications.
C. While assessing pain is important, doing it just once a shift may not be sufficient. The nurse should assess pain more frequently, especially before and after meals, as pain from oral lesions can significantly impact a client’s ability to eat.
D. Offering small, frequent meals is typically more effective in improving nutrition for clients with painful oral lesions. The client may be more willing to eat smaller amounts rather than large meals, especially if pain is a significant issue.