Lung Cancer Flashcards
Lung Cancer
-Risk Factors
- Age >50 yrs
- Genetics
- Cigarette smoking tied to LC 80% of the time
- Exposure to ionizing radiation and inhaled irritants (asbestos)
- Radon (accumulates in closed spaces)
Lung Cancer
-Statistics
- Leading cause of cancer death in US
2. All races affected equally
Lung Cancer
-Primary Goal
- Prevention of the disease must be a primary goal for all health care providers
Lung Cancer
-Diagnostics
- Chest X-ray
- Sputum Specimen
- Bronchoscopy
- CT
- CBC, LFT’s TB, Pulmonary function tests & ABG’s
Lung Cancer
-Arise from Where?
- Bronchogenic carcinomas account for 90% of primary lung cancers
Lung Cancer Cell Types
-Small-cell (Oat Cell) Carcinoma
- 20-25% of all lung cancers
- Central lesion w/ hilar mass common
- SIADH, Cushing’s syndrome, thrombophlebitis - Aggressive Tumor
- Greater than 40% of clients have distant metastasis at time of presentation
Lung Cancer Cell Types
-Adenocarcinoma
- 20-40% of all lung cancers
- Peripheral mass involving bronchi
- few local symptoms
- hypertrophic pulmonary osteoarthropathy - Early metastasis to CNS, skeleton, and adrenal glands
Lung Cancer Cell Types
-Squamous Cell Carcinoma
- 30-32% of all lung cancers
- Central lesion located in large bronchi
- client presents w/ cough, dyspnea, atelectasis, and wheezing
- hypercalcemia common - Spreads by local invasion
Lung Cancer Cell Types
-Large-Cell Carcinoma
- 10-15% of all lung cancers
- Usually peripheral lesion that is larger than associated w/ adenocarcinoma
- Tends to cavitate; gynecomastia, thrombophlebetis - Early Metastasis
Lung Cancer
-Primary Choice for Treatment
- Chemotherapy
Superior Vena Cava Syndrome
- Complication of lung cancer
- Results from pressure placed on the vena cava by a tumor
- It is a Medical Emergency
Superior Vena Cava Syndrome
-Early Signs
- Edema in the face & neck and peripherally
- Nosebleeds
- Dyspnea
Superior Vena Cava Syndrome
-Late Signs
- Mental status changes
- Cyanosis
- Hemorrhage
- Hypotension
Multi-system Effects of Lung Cancer
-Respiratory
- Cough
- Hemoptysis
- Wheezing and dyspnea
- Chest pain, dull or pleuritic
- Hoarseness and dysphagia
- Pleural Effusion
Multi-system Effects of Lung Cancer
-Cardiovascular
- Compression of the superior vena cava
Multi-system Effects of Lung Cancer
-GI
- Anorexia
Multi-system Effects of Lung Cancer
-Endocrine
- Hypercalcemia
- Hyperphosphatemia
- Cushing’s syndrome
- SIADH
- W/ water retention and hyponatremia
Small Cell Lung Cancer
-Treatment of Choice
- Combination chemotherapy is treatment of choice for small-cell cancer because of its rapid growth
Lung Cancer
-Nursing Dx
- Ineffective Breathing Pattern
- Activity Intoerance
- Pain
- Anticipatory Grieving
Lung Cancer
-Ineffective Breathing Pattern
- Assess & document RR, depth, lung sounds q4
- Frequently assess pain and provide analgesics
- Elevate head of bead above 60 degrees
- Turn, cough, deep breath
- Suction airways as needed and provide chest percussion and postural drainage
Lung Cancer
-Activity Intolerance
- Plan rest periods between activities
- Teach measures to conserve energy while performing ADL’s
- Keep frequently used objects w/in reach
- Administer O2 as prescribed
Lung Cancer
-Pain
- Assess and document using standardized pain scale
- Provide analgesics
- For cancer pain, maintain around the clock pain mgmt schedule
- Provide and assist w/ comfort measures
Lung Cancer
-Anticipatory Grieving
- Spend time w/ client and family
- Answer questions honestly
- Encourage client and family to express feelings
- Help identify strengths and coping measures
Lung Cancer
-Interdisciplinary Care
- Respiratory Therapy
- Radiology
- Nutritional services
- Rehabilitation
- Hospice