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NUR 1015 Lung Cancer - Med surg Template
- Course
- NUR 1015
- Institution
- Laboure College
This is a comprehensive and detailed template on Lung Cancer - Med surg.
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13-11Lung cancer
Assessment Labs & Diagnostics
What am i ? ❖ Possibly no symptoms. Exposure to
❖ Cytologic sputum analysis shows diagnostic
evidence of pulmonary malignancy.
Malignant tumors arising from the
carcinogens, chronic cough or a ❖ Complete blood cell count may reveal
respiratory epithelium
change in the cough, hemoptysis, anemia, leukocytosis, or hypercoagulable
● Typically divided into two
dyspnea, dysphagia chest or disorders.
major groups:
abdominal pain, hoarseness, fatigue. ❖ Liver function test results are abnormal,
Small-cell (less common) especially with metastasis.
anorexia
Non–small-cell, which is further divided ❖ Serum calcium level test may be elevated
❖ Dyspnea on exertion, use of
histologically into adenocarcinoma,
accessory muscle for breathing; nasal with bone metastasis.
squamous cell carcinoma, and large
flaring, digital clubbing, edema of the ❖ Arterial blood gas analysis may reveal
cell carcinoma. evidence of hypercarbia, hypoxia, and
face, neck, and upper torso, dilated
Most common site is wall or epithelium
chest and abdominal veins (superior acidosis.
of bronchial tree. Poor prognosis for
vena cava syndrome), weight loss, ❖ Chest radiography may show advanced
most patients, depending on the extent
enlarged lymph nodes, enlarged liver lesions and can show a lesion up to 2 years
of the cancer, when it was diagnosed,
(with liver metastasis), decreased or before signs and symptoms appear; findings
and the cell growth rate (5-year survival
absent breath sounds, wheezing, may indicate tumor size and location. It may
after diagnosis in only about 13% of
pleural friction rub. reveal mediastinal widening, atelectasis, hilar
patients)
enlargement, or pleural effusion.
❖ Contrast studies of the bronchial tree (chest
Patho Treatments computed tomography [CT], bronchography)
demonstrate size and location as well as
Patients with lung cancer
❖ Chemotherapy drug combinations: Non-small cell: spread of the lesion.
demonstrate bronchial epithelial
carboplatin (Paraplatin) or cisplatin (Platinol), ❖ Bone scan is used to detect metastasis.
changes progressing from
❖ Targeted drug therapy (in combination with ❖ Computed tomography scanning (thorax) of
squamous cell alteration or
chemotherapy) such as afatinib (Gilotrif), the chest is performed to detect malignant
metaplasia to carcinoma in situ. pleural effusion and of the brain to detect
bevacizumab (Avastin)
Tumors originating in the bronchi
❖ Immunotherapy, such as gefitinib (Iressa), erlotinib metastasis.
are thought to be more mucus
(Tarceva), crizotinib(Xalkori), PD-1/PD-L1 inhibitors; ❖ Positron emission tomography aids in the
producing. Partial or complete
nivolumab (Opdivo) and pembrolizumab (Keytruda) diagnosis of primary and metastatic sites.
obstruction of the airway occurs
❖ Antiemetics, such as ondansetron hydrochloride ❖ Magnetic resonance imaging may reveal
with tumor growth, resulting in
(Zofran), tumor invasion.
lobar collapse distal to the tumor. ❖ Gallium scanning of the liver and spleen help
Early metastasis is present in ❖ Corticosteroids for brain metastasis and spinal cord
compression (small-cell lung cancer) detect metastasis.
other thoracic structures, such as ❖ Peak expiratory flow monitoring may reveal
❖ Analgesics
hilar lymph nodes, the bronchi, airflow obstruction.
❖ Anti-anxiety medications
carinal lymph nodes, and the ❖ Bronchoscopy can help identify the tumor
mediastinum. Distant metastasis ❖ Supplemental oxygen therapy
❖ Partial removal of lung (wedge resection, segmental site. Bronchoscopic washings provide material
to the brain, liver, bone, and for cytologic and histologic study.
adrenal glands occurs. resection, lobectomy, radical lobectomy)
❖ Total removal of lung (pneumonectomy, radical ❖ Needle biopsy of the lungs (relies on biplanar
fluoroscopic visual control to locate peripheral
pneumonectomy)
tumors before withdrawing a tissue specimen
Causes for analysis) confirms the diagnosis in 80% of
patients.
❖ Tobacco smoking is ❖ Tissue biopsy of metastatic sites (including
major cause (90%) supraclavicular and mediastinal lymph nodes
and pleura) is used to assess disease extent.
Risk Factors
Based on histologic findings, staging describes
❖ Smoking (16-fold Interventions the disease extent and prognosis and is used
❖ Monitor vitals & respiratory to direct treatment.
increase in risk)
❖ Status ❖ Mediastinoscopy is used to evaluate enlarged
❖ Exposure to secondhand ❖ Maintain patent airway lymph nodes identified on CT scans.
smoke or radon gas ❖ Daily weights ❖ Thoracentesis allows chemical and cytologic
❖ Exposure to carcinogenic ❖ Meticulous skin care examination of pleural fluid.
❖ Provide support
and industrial air ❖ Exploratory thoracotomy is performed to
❖ Turn patient frequently
pollutants (asbestos, ❖ Offer a high calorie foods with small frequent obtain biopsy specimen.
arsenic, chromium, coal meals.
dust, iron oxides, nickel,
radioactive dust, and
uranium)
❖ Genetic predisposition
❖ Pulmonary fibrosis
❖ Radiation therapy www. SimpleNursing.com
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