Lung And Laryngeal Cancer Flashcards
Primary vs. Metastatic
Primary: starts in the lungs
Metastatic: comes from elsewhere in the body
1) What is the leading cause of lung cancer?
2) Other risk factors
1) A history of Smoking for more than 20 years
2) Asbestos, beryllium, chromium, coal, cobalt, iron oxide, mustard gas, petroleum, radiation, air pollution, genetics
1) Who should be screened for lung cancer?
2) Two types of lung cancer
1) Adults 55-77 with a Hx of smoking of quit less than 15 years ago should be screen annually
2) Small cell and Non small cell
Types of Non Small cell lung cancer
- Epidermoid
- Adenocarcinoma
- Large cell
Small Cell Lung Cancer
1) Growth
2) What is it associated with?
3) Treatment
1) Fast and aggressive
2) Smoking and paraneoplastic syndrome
3) Chemo and radiation. Surgery not helpful
Epidermoid Carcinoma
1) What does it look like?
2) What is it associated with?
3) Growth
4) Where is it found?
1) Squamous cell
2) Smoking
3) Slow
4) The bronchi and peripheral tissues
Adenocarcinoma
1) What group is it associated with?
2) Where is it found?
1) Nonsmokers and women
2) Peripheral lung tissue
Tumor Grading
1) Gx
2) G1
3) G2
1) Can’t be determined
2) Tumor cells closely resemble normal cells
3) Tumor cells have some normal characteristics but also have malignant ones
Tumor Grading
1) G3
2) G4
1) Tumor cells are poorly differentiated but tissue of origin can still be determined
2) Tumor cells have no normal characteristics and tissue of origin may not be established
Tumor Staging
1) Tx
2) To
3) Tis
4) T1-4
1) Primary tumor can’t be assessed
2) No evidence of primary tumor
3) Carcinoma in situ: tumor is localized
4) Increasing size of tumor
Node
1) Nx
2) No
3) N1-3
1) Regional lymph nodes can’t be assessed
2) No regional lymph node metastasis
3) Increasing involvement of regional lymph nodes
1) Mx
2) Mo
3) M1
1) Distal metastasis can’t be assessed
2) No distant metastasis
3) Distant metastasis
Pulmonary S&S of Lung Cancer
- Persistent Cough- most common symptom
- Hemoptysis
- SOB
- Unilateral wheeze
- Pain on inspiration
- Friction Rub
- Pleural Effusion
- Edema of face and neck
- Clubbing of fingers
Dx Tests for Lung Cancer
- CXR
- CT Scan, MRI, PET
- Sputum collection
- Fiberoptic Bronchoscopy
- Thoracentesis
- Biopsy
1) What is the first Dx test?
2) What does it show?
3) What is definitive for Dx?
1) CXR
2) White patches in the lungs
3) Biopsy
What medications are used to treat lung cancer?
- Chemo- give the lowest dose possible
- Morphine for pain
- Bronchodilators open up the airways; Albuterol
- Mucolytics to help loosen secretions
Tx for Lung Cancer
- Radiation
- Chemo
- Thoracentesis
- Surgery- lobectomy or pneumonectomy
- Pleurodesis
Nursing Dx for Lung Cancer
- Impaired Gas Exchange
- Pain
- Activity intolerance
- Disturbed body image
- Knowledge deficit
Risk Factors for Laryngeal Cancer
- Smoking
- Alcohol consumption
- Marijuana
- Poor oral hygiene
- HPV
S&S of Laryngeal Cancer
- Hoarseness that lasts more than 2 weeks
- Erythroplakia and Leukoplakia
- Ear pain
- Ringing in the ears
- Swelling or lumps in the neck
- Constant coughing
Dx Test for Laryngeal Cancer
- Fiberoptic laryngoscopy
- CXR
- Barium Swallow
- CT, MRI, SPEC, PET
- Biopsy
Surgical Interventions for Laryngeal Cancer
- Hemilaryngectomy
- Subtotal laryngectomy
- Supraglottic laryngectomy
- Total/Partial laryngectomy
- Radical Neck Dissection
- Tracheostomy
- Neck dissection
1) What position should patients be in post op?
2) What meds should be given before meals?
1) Semi Fowler
2) Anitemetics or analgesics
Radiation Therapy
Side effects and treatments
- Dry mouth- increase fluids; mouth rinses; pilocarpine hydrochloride
- Oral mucositis: oral care
- Fatigue: walking 15-30mins a day
Pts teaching for radiation
- Pts should always carry a water bottle
- Don’t use lotions within 2 hrs of Tx
1) Tracheostomy
2) Function
1) Surgically created stoma in the trachea
2) Establish patent airway
Facilitate removal of secretions
Long term mechanical ventilation
Tracheostomy
1) How should pt be positioned during procedure?
2) How to confirm placement?
3) What should stoma be cleaned with?
1) Supine
2) Auscultate the pts chest for air entry
3) Normal saline
Tracheostomy
1) What should be done before suctioning?
2) What should be avoided for the first 24hrs?
3) Who should assess swallowing and risk for aspiration?
1) Give humidified air
2) Avoid changing tapes
3) Speech therapist
What to do if tracheostomy tube becomes displaced?
- Call HCP
- Assess LOC, ability to breathe and for respiratory distress
- If respiratory distress, use hemostat to open up stoma
- If tube can’t be replaced, place pt in semi Fowlers
Indications for suctioning
- Coughing
- Crackles/wheezes
- Increase in peak inspiratory pressure
- Restlessness/Agitation
1) What is the priority during suctioning?
2) When should it be stopped?
1) Assess O2 before, during, and after
2) If pts becomes bradycardic, hypotensive, dysthymias, or decrease in SPO2
