Neoplasms #4 (1)

Question 1

Clinical Manifestations of Lung Cancer

Answer 1

1. Often clinically silent
2. Symptoms nonspecific and appear late in disease
   
   1. Persistent Cough
   2. Dyspnea
   3. Chest pain
   4. Anorexia
   5. Fatigue
   6. Weight loss

Question 2

Risk Factors for Lung Cancer

Answer 2

1. Cigarette Smoking
2. 85-90% of all lung cancers are smoking related
3. Inhaled carcinogens
4. Preexisting pulmonary disease

Question 3

Screening Methods for Lung Cancer

Answer 3

• Low dose CT recommended for high risk individuals
  
  • High risk includes current smokers ages 55-74 with a 30 pack year smoking history OR those who have quit smoking within the past 15 years
• Smoking Cessation and prevention are essential to reduce lung cancer risk

Question 4

Surgical Interventions and Treatment for Lung Cancer

Answer 4

1. Lobectomy
2. Pneumonectomy
3. Radiation
4. Chemotherapy
5. Biologic Therapy
6. Targeted Therapy

Question 5

Lobectomy

Answer 5

Removal of one or more lobes of the lung

Question 6

Pneumonectomy

Answer 6

Removal of the entire lung

Question 7

Wedge Resection

Answer 7

Removal of a pie shaped section from surface of lung

Question 8

What should be the positioning of a patient who just had surgery on a lung?

Answer 8

Position on back or operative side with head elevated

Question 9

Thoractomy

Answer 9

Surgical opening in the thoracic cavity

Question 10

Sitz Bath

Answer 10

• Allows application of moist heat to perineal/rectal area
• May be ordered for a paitent following a surgery that uses an abdominal/perineal approach such as an abdominal/perineal prostatectomy
• Area submerged in water
• Portable unit that fits into the toilet can be used
• Bath relieves soreness and pain
• Cleanses the area and increases circulation which promotes healing
• Temp should be 105-110F unless patient is unable to tolerate heat

Question 11

Nursing Interventions for Sitz Bath

Answer 11

1. Set up portable unit on toilet. Position drainage ports to rear of toilet
2. Have patient void before procedure
3. Remove any external dressings. Assess area being treated
4. Assist the paitent onto the sitz unit
5. Provide a blanket for the patient’s shoulders
6. Observe the patient closely during the bath. The duration of the bath is generally 15-20 minutes
7. Maintain the water temperature
8. After procedure reapply dressings as prescribed. Allow for rest period afterwards. Clean equipment.

Question 12

What/When/Where to document sitz bath

Answer 12

What:

Method - Sitz Bath, Area of Application, Duration, Patient Response

When:

Every 8 hours and/or as prescribed

Where:

Nursing Progress Note or Flowsheet

Question 13

Cup Voiding

Answer 13

A method of monitoring urinary volume and contents following removal of a foley catheter. Most often, a physician orders cup voiding after bladder/prostate surgery to ensure that the patient is voiding in sufficient amounts and the amount of blood in the urine is decreasing.

Question 14

Nursing Interventions for Cup Voiding

Answer 14

1. Bring several clean urine specimen cups, lids, and a marker to the patient’s bedside
2. Instruct the patient to:
   
   1. void into a new specimen cup with each void
   2. mark the time of each void on the cup or lid
   3. line the cups up in a place where they won’t be disturbed
3. Assess contents of cups, intake, and output. Document information according to agency policy
4. Empty and discard cups per agency policy after specimen examined by MD

Question 15

What/When/Where to document for cup voiding

Answer 15

What:

Description of drainage, amount of drainage, patient teaching

When: Each cup void

Where:

Nurse’s note or flowsheet

Urine output on I&O Flowsheet