COPD & Respiratory Tract Malignancies
Terms
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- Complications of interventions for lung cancer
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*surgery-DVT, pneumonia, inf, impaired gas exchange
*chemo-n/v, anemia, renal failure, thrombocytopenia, liver damage, CHF, SIADH, peripheral neuropathy, diarrhea, myelosupression
*radiation-fatigue, skin reactions, esophagitis, pneumonitis, hair loss - Manifestations of lung cancer
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*majority asymptomatic during early stages of disease
*as tumor grows: persistent cough, chest pains, hemoptysis, dyspnea, wheezing and recurrent pneumonia; wt loss, fatigue, anorexia
*with metastasis, bone pain, jaundice and HA may occur - Diagnosis of Emphysema
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*Pulmonary function test (PFT)
- <forced exp. vol, prolonged expir
- <maximum voluntary ventil.
- <forced vital capacity
- ^ total lung capacity
- ^ residual volume
*chest xray (enlarged thoracic cage, flat diaphragm, elongated and narrow cardiac silhoutte) - Emphysema
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*abnormal distension of air spaces beyond term. bronchioles with destruction of walls of alveoli
*panlobular type (pink puffer)
*centrilobular type (blue blo)
*A-P/transverse diam. 2:1 - Medications for COPD
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*bronchodilators PO, SQ, IV, inhaled s/e: tachycardia, cardiac arrhythmias, CNS excitation, n/v
*corticosteroids PO, IV, inhaled s/e: hyperglycemia, CNS changes, HTN, masks inf, ^risk of inf, osteoarthritis, ^Na & H2O retention (causes ^BP) - Medical Management & Nursing Interventions for COPD
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*Improve Gas exchange:( aerosol therapy, albuterol nebs, Oxygen)
*remember: hypoxia is stim for respirations
*Nsg interventions: pursed lip breathing
*Remove bronchiap secretions (CPT, postural drainage, ^fluids)
*prevent inf: (flu & pneumonia shots) - Therapeutic Interventions of Lung cancer
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*non-small cell CA is managed with surgery, chemo and/or radiation
*small cell Ca is managed with chemo and radiation (poorer prognosis) - Therapeutic Interventions for Emphysema
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*maximize quality of life, minimize complications
*teach how to breathe, so not SOB
*pulm rehab - Cancer of the larynx
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*supraglottis (includes epiglottis)
*glottis (2/3 of all cancers)
*subglottis - Nursing Assessment
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*what are you going to look for in your interview and physical exam?
*what kind of nsg dx are pertinent to this pt?
*do you know how to suction & do trach care on this patient? - Diagnostics of Ca of larynx
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*History & exam
*CXR & barium swallow
*MRI
*laryngoscopy
*pandendoscopy (views larynx, esophagus, trachea & bronchi) - Treatment of Ca of larynx
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*radiation & surgery; sometime chemo
*partial laryngectomy (preserves voice)
*total laryngectomy (most common) pt will have permanent tracheal stoma
*radical neck dissection (lymph nodes, epiglottis & sternomastocleod muscle removed) - Pre-op Ca of larynx
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*consent
*normal bloodwork
*how pt will communicate afterward - Post-op: CA of larynx
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*maintain airway
*remove secretions
*relieve pain
*communication
*complications: bleeding, infect, resp. complications
*esophageal speech, electronic larynx, TEP - Diagnostics for lung cancer
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*CXR
*Chest CT
*cytological examination-2 ways (bronchoscopy, sputum culture)
*bronchoscopy
*bone scan
*liver scan
*head CT - Nursing assessments of COPD
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*what are you looking for in physical exam and interview?
*what complications are this pt at risk for that you will be monitoring?
*what nsg dx are approp for this pt? - Nursing assessment of lung cancer
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*Looking for cough patterns, wheezing, chest tightnes, hemoptysis, blood tinged sputum, dyspnea, hoarseness
*factors ^ risk: smoking
*nsg dx?