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TL Lung Cancer
Nursing of the adult with lung cancer (HESI)
| Question | Answer |
|---|---|
| Define Lung Cancer. | Neoplasm occurring in the lung |
| How does lung cancer rank among cancer deaths in the U.S. ? | Lung cancer is the leading cause of cancer deaths |
| What single factor is responsible for 80-90% of all lung cancers? | cigarette smoking |
| Other than smoking, name some causes of lung cancer. | occpupational hazards like asbestos and radioactive dust |
| How long after exposure does lung cancer develop? | years after – commonly in the 5th and 6th decade of life |
| Describe the prognosis and survival rate for lung cancer. | poor prognosis; 5 year survival rate is approximately 14% |
| What signs and symptoms is the nurse likely to find on assessment of the client with lung cancer? | dry hacking cough early, productive with progression; hoarseness, dyspnea, hemoptysis, rust colored/purulent sputum, chest pain, diminished breath sounds, occasional wheezing |
| What labs and diagnostic test will identify lung cancer? | chest radiograph, sputum for cytology and pleural fluid |
| Give 5 applicable nursing diagnoses for lung cancer. | Chronic pain, ineffective breathing pattern, impaired gas exchange, imbalanced nutrition less than, anxiety |
| What nursing interventions help the client with breathing and oxygenation? | Semi-fowler position, pursed lip breathing for improved gas exchange, relaxation techniques to relieve anxiety about breathing difficulty, administer O2 as indicated by ABGs and O2 saturation |
| What nursing interventions help to allay the patient’s anxiety? | Provide client/family information about impending tests and procedures, give as much control as possible over personal care, encourage verbalization of concerns |
| What is important to keep in mind for the patient with lung cancer while administering analgesics for pain management? | Respiratory depression |
| What are the surgical options for the treatment of lung cancer? | Thoracotomy, pnemonectomy, Lobectomy and segmental resection |
| Which clients would be served by a thoracotomy? | those with a resectable tumor – unfortunately, detection often occurs after the tumor has spread to much for this option |
| Define pneumonectomy. | removal of an entire lung |
| How should the pneumonectomy client be positioned? | on operative side or back |
| Discuss the use of chest tubes for the pneumonectomy client. | Chest tubes are not usually used because it is preferred that the empty space left by the removal of lung tissue fill with fluid to prevent the shift of the remaining chest organs into it. |
| Discuss client positioning and chest tubes after a lobectomy and segmental resection. | Position client on back; chest tubes are usually inserted; ensure that tubing is not kinked or obstructed |
| List the nursing responsibilities directly related to chest tubes and drainage system. | keep tubing coiled loosely below chest level/connection tight and taped, check that drainage system is upright and below client’s chest |
| What are the nursing responsibilities regarding the suction control chamber of the chest drainage system? | maintain water level in suction control chamber |
| What is the nurse’s job related to the collection chamber? | mark drainage and time of assessment on collection chamber; nature of drainage |
| What does the nurse assess for in the water seal chamber? | for fluctuation/bubbling |
| What interventions are directed to the client? | encourage deep breathing, monitor clinical status |
| What are the nursing responsibilities directly related to the insertion site? | Maintain dry occlusive dressing, Check for skin irritation, signs of infection, subcutaneous emphysema, leaks, drainage |
| Name three “Do nots” related to chest tubes? | Do not empty collection container, Do not strip or milk chest tubes, Do not clamp chest tubes (exceptions) |
| What does the nurse do if the drainage system breaks? | place the distal end of the chest tubing connection in a sterile water container at 2 cm level as an emergency water seal |
| What should the nurse do and not do if the chest tube becomes disconnected? | place end in container of sterile water or saline, do not clamp |
| What should the nurse do if the chest tube is removed from the client? | apply pressure with an occlusive dressing and immediately notify MD |
| What are fluctuations in the water seal chamber indicative of? | no external suction, system is intact |
| What should the nurse check/do if fluctuations in the water seal chamber cease? | kinked tubing, collection of fluid in the tubing, occlusions, change the clients position because expanding lung tissue may be occluding the tube opening |
| Most hospitals don’t milk chest tubes as a means of clearing or preventing clots. What kind of tube may involve orders to be stripped and why? | Mediastinal - because of their location compared to the larger thoracic cavity tubes |
| Name 3 things the nurse should keep in mind when the patient is receiving chemotherapy. | attend to immunosuppression factor, administer antiemetics before chemotherapy, take precautions administering antineoplastics |
| Name 4 interventions related to radiation therapy. | skin care according HCP request; instruct client not to wash off radiologist’s lines and to wear soft cotton garments only; don’t use powders or creams on radiation site unless specified by the radiologist |
| Name several pathophysiologic conditions that can be related to the nursing diagnosis, “ineffective breathing pattern”. | Air sacs don’t fill and empty properly ( emphysema, cystic fibrosis), Obstruction of air passages (carcinoma, asthma, chronic bronchitis), fluid in the air sacs (pneumonia), respiratory fatigue (COPD, pneumonia) |
Created by:
Perseverandovercome
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