Lung Cancer And

Lobectomy

Group members: Jonice Daly

Marissa Matthews
Vikram Sukhlal
Michelle Ketwaroo

Objectives
Review

anatomy of lungs.
Define lobectomy and lung caner .
Understand the risk factors, methods of detection,
and medicalsurgical management.
Demonstrate

nursing skills when caring for a

patient with lobectomy.

Definition of topic
Lung

Cancer
Definition: Lung cancer is the uncontrolled
growth of abnormal cells that start off in one or
both lungs; usually in the cells that line the air
passages.

Lobectomy

Definition: A lobectomy is a surgery to remove

one lobe of the lungs.

Etiology
Risk Factors
Tobacco

Smoke
Second Hand Smoking
Environmental And Occupational Exposure
Genetics
Dietary factors

Pathophysiology

Clinical Manifestations
Early Manifestations
Coughing
Late Manifestations
Bone Pain
Headache
Shortness of Breath
Pain to Chest Area
Wheezing
Hoarse Voice
Loss of Weight

Bronchoscopy
Diagnostic
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Tests

Bronchoscopy
Lung needle biopsy
Mediastinoscopy withbiopsy
A lung positron emission tomography (PET) scan
Computed tomography (CT) scan
Magnetic resonance imaging (MRI) scan
Sputum cytology
Thoracentesis
Thoracoscopy
Molecular tests

Lung Needle

Medical Management
Chemotherapy And Radiation.
Usually there is a combination of cisplatin or carboplatin
(Paraplatin) with one of the following:
1.

Vinorelbine

2.

Gemcitabine

3.

Paclitaxel (Taxol)

4.

Docetaxel

Surgical Management
Preoperative

management

Assessment

Chest auscultation
The nurse assesses for crackles and wheezes
Patient history and assessment

Before

surgery
- Informed consent
Relieving anxiety
anesthesia
- Arterial line
- Foleys catheter

- Patient education
- General
-

IV line

 During

surgery
- The patient will be placed on their side.
- The affected lobe will be removed and the
airway tubes tightly sewn together.

After

surgery
- Monitor vital signs
Sleeve Resection
- Dressing should be repadded
- An inspirometer will be used
- The patient will not be able to eat or drink
anything.
- compression stockings/ anti-embolism stockings
Bilobectomy
- Monitor oxygen saturation continuously
Segmentectomy

Nursing Management according to Maslows

Hierarchy Of Needs
Physiological Needs

Oxygen

Assess Respiration; quality, rate, pattern depth and breathing effort.

Assess for any life threatening problems ; respiratory arrest, flail chest, sucking
chest wound. Auscultate lung sounds

Assess for signs of hypoxemia

Suction if cough is weak or breath sounds not cleared by cough effort.

Assess skin for deviations

Assist patient with coughing and deep breathing techniques.

Administer supplemental oxygen via nasal cannula, partial rebreathing mask, or

high-humidity face mask, as indicated.

Administer bronchodilators, expectorants, and/or analgesics as indicated.

Observe amount and character of sputum or aspirated secretions. Investigate

changes as indicated.

Administer medications knowledgeably.

Nutrition

Assess for signs of dehydration or fluid overload

Ensure that iv in infusing at correct rate

Ensure adequate fluid intake (at least 2500 mL/day) within cardiac tolerance.

Diet: Iron and vitamins preferably from fresh fruits and

vegetables

Review nutritional and/or fluid needs. Suggest gradually

increasing protein and use of high-calorie snacks as
appropriate.

Elimination

Monitor patients urinary output in comparison with oral and

intravenous intake

Ensure fluid balance in 24 hours

Assess urine not only by amount.

Assess patients sputum after coughing exercises

Assess bowel elimination patterns

Assess wound drainage and dressing odours and amount

Safety And Security

Maintain oxygen saturation above 95% as required

Use of proper suctioning technique

Using proper hand washing and sterile techniques to

 Love

And Belonging
- Encourage patients relatives to make
frequent visits
Connect with religion and faith
Family members should be encouraged to
shower patient with positivity which is really
needed at this time.
Promote trust: Show empathy and caring,
demonstrate respect
for culture and values, offer support and
reassurance, be
honest, engage in active listening.
Listen to the dying patient and family for
signs of denial.
Assist the patient in exploring reasons for
living and promote hope.

Self Esteem

Some

people worry about how their body changes

will impact on relationships with others, especially
intimate relationships.

Encourage patient to enhance physical.

Self Actualization
Teach

patient about care of incisional site

Teach patient of importance of deep breathing
exercises
Encourage ambulation at home
Promote rest.

Reference
Textbook

of Medical Surgical Nursing

By Brunner and Suddarth
12th Edition pg. 486 681