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Tuesday, October 18, 2011

RESPIRATORY NOTES V

Bronchogenic Cancer

-pathologic changes:

-non-specific inflammation -hypersecretion of mucus

-hyperplasia -obstruction

2 Major categories

-Small Cell CA

-Non Small Cell CA

a. squamous cell b. adenoCA c. large cell CA

Risk Factors

-inhaled carcinogens

-existing pulmonary disorder

-familial tendency

S/SX

-persistent cough -chest pain -dyspnea

-fatigue -anorexia -pallor -weight loss

Diagnosis

-CXR

-Sputum microscopy

-Bronchoscopy

-Thoracentesis

-Biopsy of scalene nodes

Management

-Radiation

-Chemotherapy

-Surgery

-Pneumonectomy

-removal of entire lung

-position: operative side or affected part

-no chest tube

-Lobectomy

-removal of 1 lobe

-position: unaffected part to promote expansion of affected lung

-compensatory emphysema of remaining lung fills the thoracic space

-Segmental Resection

-remove 1 or more segment

-Wedge Resection

-remove a lesion that occupy only a segment of the lung

Nursing Care

a. provide adequate ventilation

b. suction secretions regularly

c. pain relief

d. ROM exercises

e. high protein diet, adequate fluid

COMPLICATIONS

a. Respiratory Insufficiency

b. Pneumothorax

c. Subcutaneous Emphysema

d. Pulmonary Embolism

e. Pulmonary Edema

f. Bleeding

g. Shock

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