lungs cancer
TRANSCRIPT
WHAT IS IT?
LUNG CANCER
IS THE MALIGNANCY
IN THE EPITHELIUM OF
THE RESPIRATORY TRACT
(Luckmann & Sorennsen 1993)
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HOW TO CLASSIFY?
Clinically, grouped into 2 divisions
SMALL CELL LUNG CANCER (Oat Cell)
NON SMALL CELL LUNG CANCERSquamous Cell Epidermoid
Adenocarcinoma
Large Cell
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SMALL CELL LUNG CARCINOMA
20-25% of lung cancer
Rapid growth
Metastasis to mediastinum,thoracic and extra thoracic structures
May narrow bronchi (compression)
Causes hoarseness (paralysis of laryngeal nerve)
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NON SMALL CELL LUNG CARCINOMA
SQUAMOUS CELL/ EPIDERMOID
30-35% of lung cancer
Arise from bronchial epithelium
Cavitation may also occur
Slow growth, metastasis not common
Secondary infections distal to obstructive tumor in bronchioles frequently occur
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NON SMALL CELL LUNG CARCINOMA
ADENOCARCINOMA25-30% of lung cancerArise from bronchiole mucus glandSlow growth, may metastasizeRarely cavityStrongly linked to cigarette smokingBronchiolo alveolar cell carcinoma is a subtype
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NON SMALL CELL LUNG CARCINOMA
LARGE CELL CARCINOMA
10-20% of lung cancer
Cavitation common
Slow, metastasis may occur to kidney, liver and adrenals
May be located centrally, mid lung or peripherally
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HOW DOES THE CANCER SPREAD/ METASTATIZE?
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CAUSES AND RISK FACTOR
Smoking (heavy smoking?)
Exposure to secondhand smoke
Family history of lung cancer
Exposure to asbestos and other chemicals
Air pollution (urban vs rural)
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SIGN AND SYMPTOMS
Chronic persistent cough( obstructs airflow)
Coughing up blood, sputum streaked with blood
Any change in respiratory pattern
Weight loss and loss of appetite.
Difficulty swallowing.
Swelling in the neck and face.
Pericardial effusion and temponade04/11/23 www.health-nurses-doctors.blogspot.com
SIGN AND SYMPTOMS
Chest pain ,shoulder, or back pain that does not go away and often gets worse with deep breathing SOB, dyspnea and wheezing Repeated bouts of pneumonia or bronchitis Hoarseness that lasts more than two weeks Increasing fatigue and weakness. Clubbing of the fingers and toes
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SIGN AND SYMPTOMS
Horner’s Syndrome (miosis pupil contraction, partial eyelid ptosis, anhidrosis absence of sweating)
Tumor rib involvementbone pain sympathetic nerve ganglia
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Diagnosis
Chest X-RaySputum cytologyCT scanMRI scanBronchoscopyLung biopsy /percutaneous needle biopsy/ mediastinoscopy
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Treatment
General health
Type of lung cancer (small cell or non-small cell)
Size and position of the tumour
Stage
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SURGICAL MANAGEMENT
Wedge Resection: Involves the removal of a small localized area of diseased tissue near the surface of the lung. Pulmonary functions & structures remain unchanged.Segmental Resection: involves the removal of one or more lung segments (a bronchiole and its alveoli) the remaining lung tissue over expands to fill the space.Lobectomy: lobectomy involves removing an entire lobe of one lung.
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SURGICAL MANAGEMENT
Pneumonectomy: an entire lung is removed.
HOW WOULD THE
PATIENT BREATHE
THEN??
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Once the lung is removed, the involved side of the thoracic cavity is an empty space.In order to reduce the size of this cavity, the phrenic nerve is severed on the affected side to paralyze the diaphragm in an elevated positionThoracoplasty may also be performed to further reduce the thoracic space
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MEDICAL MANAGEMENT
Radiation therapy
Chemotherapy
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NURSING MANAGEMENT:
Assessment: Respiratory assessmentLab investigations and other diagnostic
tests Patient’s knowledge and understanding of
diagnosis and treatment,Patient’s anxiety level and support system, Exposure to carcinogen
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NURSING DIAGNOSIS:
Ineffective airway clearance related to increased tracheobroncheal secretion
Anxiety related to lack of knowledge Pain related to the pressure of the tumorAltered nutrition less then body
requirement related increased metabolic demand and decreased food intake
Ineffective breathing pattern related to decreased lung capacity
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NURSING INTERVENTION
Monitor S/S of respiratory failure Monitor results of chest X-ray examinations, lab
values and other investigations Administer chemotherapy and other desired
medications Educate patient with their disease and its progression Provide opportunity to the client to ventilate his
feelings Identify their support system Post surgery care Care of patients with chest drainage
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Health promotions/teaching:Abstinence from smoking:
Determine the cause /factors of smoking and help client abstinence from smoking
Nicotine therapy or Non nicotine therapyUse of nicotine patch, gum, nasal spray, inhaler
Dealing with urge to smokingCounseling/ support groupDiscussion with any Ex smokerAvoid RelapseChange environment
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Prevention
Stop smoking.
Avoid secondhand smoke
Avoid carcinogens at work. Take precautions to protect yourself from exposure to toxic chemicals at work.
Eat a diet full of fruits and vegetables. Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best.
Exercise
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CONCLUSION
WHAT U R IS
HOW DO U
PERCIEVE
URSELF
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