Lower Respiratory Disorders Lung Cancer & ARDS

Lung Cancer: Leading cause of death from cancer  Major cause smoking (but don’t assume lung cancer = smoker)  Other causes: environmental exposure  2 categories: small cell lung cancer, non-small cell lung cancer  Staging: I-IV (true of all cancer)  Small cell lung cancer: o 15% of tumors, most aggressive, grows quickly, very poor prognosis  Non-small cell lung cancer: o 85% of tumors, surgery is the preferred treatment if localized and no metastasis  Diagnosis: Fine need aspiration, Chest Xray, CT Scan, MRI, Bronchoscopy, Sputum studies  Manifestations: Insidious, cough, Wheezing, Dyspnea, Hoarseness, Hemoptysis, Anorexia, Diminished or absent breath sounds  Treatment: Varies o Surgery: Pneumonectomy, Lobectomy, Segmentectomy, Wedge resection o Radiation, Chemotherapy  Surgical Interventions: o Laser therapy, thoracotomy, thoracotomy with lobectomy, thoracotomy with segmental resection  Non-Surgical Interventions: o Radiation, Chemotherapy  Lung-Cancer Nursing Interventions: o Monitor vital signs, monitor respiratory system, assess for tracheal deviation, administer pain medication (per order), oxygen (per order), administer respiratory medications (along with respiratory therapy), highcalorie, high protein, high-vitamin diet, activity as tolerated  Nursing Care post-surgery: o Maintain airway, monitor vital signs, closely monitor respiratory system, Oxygen therapy, maintain chest tube drainage system, T/C/DB, CPT, Range of motion of operative shoulder, Lots of emotional support Acute Respiratory Failure: Sudden life threating deterioration of gas exchange  Insufficient oxygen to the blood and inadequate carbon dioxide removed from the lung  PaO2 < 60 mm HG, PaCO2 > 50 mm HG, pH <7.35  Types of Acute Respiratory Failure: o Hypoxemic respiratory failure (Oxygen failure)  Insufficient oxygenation of pulmonary blood at alveolar level  Ventilation normal, lung perfusion decreased  Right to left shunting of blood  V/Q mismatch  Low partial pressure of O2