LUNG CANCER_POSTOPERATIVE CARE

LUNG - LUNG CANCER(POSTOPERATIVE CARE Lung cancer is the leading cause of cancer death in the United States and usually develops within the wall or

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LUNG CANCER (POSTOPERATIVE CARE) Lung cancer is the leading cause of cancer death in the United States and usually develops within the wall or epithelium of the bronchial tree. The two major categories are small cell lung cancers (SCLC), such as oat cell; and non–small cell lung cancers (NSCLC), which include adenocarcinoma, squamous cell and large cell carcinomas. Prognosis is generally poor, varying with the type of cancer and extent of involvement at the time of diagnosis. Survival rates are better with NSCLC, especially if treated in early stages. Although NSCLC tumors are frequently associated with metastases, they are generally slow growing. Treatment options can include combinations of surgery, radiation, and chemotherapy. Surgery is the primary treatment for stage I and stage II tumors. Selected stage III carcinomas may be operable if the tumor is resectable. Surgical procedures for operable tumors of the lung include: 1. Pneumonectomy (removal of an entire lung), performed for lesions originating in the mainstem bronchus or lobar bronchus. 2. Lobectomy (removal of one lobe), preferred for peripheral carcinoma localized in a lobe. 3. Wedge or segmental resection, performed for lesions that are small and well contained within one segment. 4. Endoscopic laser resection may be done on peripheral tumors to reduce the necessity of cutting through ribs. CARE SETTING Inpatient surgical and possibly subacute units. RELATED CONCERNS Cancer Hemothorax/pneumothorax Psychosocial aspects of care Radical neck surgery: laryngectomy (postoperative care) Surgical intervention Patient Assessment Database (Preoperative) Findings depend on type, duration of cancer, and extent of metastasis. ACTIVITY/REST May report: Fatigue, inability to maintain usual routine, dyspnea with activity May exhibit: Lassitude (usually in advanced stage) CIRCULATION May exhibit: Jugular venous distention (JVD) (with vena caval obstruction) Heart sounds: Pericardial rub (indicating effusion) Tachycardia/dysrhythmias Clubbing of fingers EGO INTEGRITY May report: Frightened feelings, fear of outcome of surgery Denial of severity of condition/potential for malignancy May exhibit: Restlessness, insomnia, repetitive questioning ELIMINATION May report: Intermittent diarrhea (hormonal imbalance, SCLC) Increased frequency/amount of urine (hormonal imbalance, epidermoid tumor) FOOD/FLUID May report: Weight loss, poor appetite, decreased food intake Difficulty swallowing Thirst/increased fluid intake
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May exhibit: Thin, emaciated, or wasted appearance (late stages) Edema of face/neck, chest, back (vena caval obstruction); facial/periorbital edema (hormonal imbalance, SCLC) Glucose in urine (hormonal imbalance, epidermoid tumor) PAIN/DISCOMFORT May report: Chest pain (not usually present in early stages and not always in advanced stages), which may/may not be affected by position change Shoulder/arm pain (particularly with large cell or adenocarcinoma)
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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LUNG - LUNG CANCER(POSTOPERATIVE CARE Lung cancer is the leading cause of cancer death in the United States and usually develops within the wall or

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