Professional Documents
Culture Documents
Bronchogenic cancer refers to a malignant tumor of the lung arising within the wall or
epithelial lining of the bronchus. The lung is also a common site of metastasis by way of
venous circulation or lymphatic spread. Bronchogenic cancer is classified according to
cell type:
Predisposing Factors
Staging
NURSING ALERT
Suspect lung cancer in patients who belong to a susceptible, high-risk group and who
have repeated unresolved respiratory infections.
Clinical Manifestations
Usually occur late and are related to size and location of tumor, extent of spread, and
involvement of other structures
1. Cough, especially a new type or changing cough, results from bronchial irritation.
2. Dyspnea, wheezing (suggests partial bronchial obstruction).
3. Chest pain (poorly localized and aching)
4. Excessive sputum production, repeated upper respiratory infections
5. Hemoptysis
6. Malaise, fever, weight loss, fatigue, anorexia
7. Paraneoplastic syndrome metabolic or neurologic disturbances related to the
secretion of substances by the neoplasm
8. Symptoms of metastasis bone pain; abdominal discomfort, nausea and vomiting
from liver involvement; pancytopenia from bone marrow involvement; headache
from CNS metastasis
9. Usual sites of metastasis lymph nodes, bones, liver
DIAGNOSTIC EVALUATION
MANAGEMENT
1. The treatment depends on the cell type, stage of disease, and the physiologic status
of the patient. It includes a multidisciplinary approach that may be used separately
or in combination, including:
a. Surgical resection.
b. Radiation therapy.
c. Chemotherapy.
d. Immunotherapy.
COMPLICATIONS
1. Determine onset and duration of coughing, sputum production, and the degree of
dyspnea. Auscultate for breath sounds. Observe symmetry of chest during
respirations.
2. Take anthropometric measurements: weigh patient, review laboratory biochemical
tests, and conduct appraisal of 24-hour food intake.
3. Ask about pain, including location, intensity, and factors influencing pain.
NURSING DIAGNOSES
NURSING INTERVENTIONS
CONTROLLING PAIN
MINIMIZING ANXIETY
• Realize that shock, disbelief, denial, anger, and depression are all normal
reactions to the diagnosis of lung cancer.
• Try to have the patient express concerns; share these concerns with health
professionals.
• Encourage the patient to communicate feelings to significant people in his life.
• Expect some feelings of anxiety and depression to recur during illness.
• Encourage the patient to keep active and remain in the mainstream. Continue with
usual activities (work, recreation, sexual) as much as possible.
PATIENT EDUCATION AND HEALTH MAINTENANCE
1. Teach patient to use NSAID or other prescribed medication as necessary for pain
without being overly concerned about addiction.
2. Help the patient realize that not every ache and pain is caused by lung cancer; some
patients do not experience pain.
3. Tell the patient that radiation therapy may be used for pain control if tumor has
spread to bone.
4. Advise the patient to report new or persistent pain; it may be due to some other
cause such as arthritis.
5. Suggest talking to a social worker about financial assistance, or other services that
may be needed.