2. Interventions: 1. Monitor vital signs 2. Monitor breathing patterns and breath sounds and for signs of respiratory impairment 3. Assess for tracheal deviation 4. Administer analgesics as prescribed for pain management
3. 5. Place in Fowler’s position for easy breathing 6. Administer oxygen as prescribed and humidification to moisten and loosen secretions 7. Provide respiratory treatments as prescribed 8. Administer bronchodilators and corticosteroids as prescribed to decrease bronchospasm, inflammation and edema
4. 9. Provide a high-calorie, high protein , high vitamin diet 10. Provide activity as tolerated , rest periods, and active and passive range-of-motion exercises 11. Monitor for bleeding, infection and electrolyte imbalances 12. Monitor pulse oximetry
5. NON SURGICAL INTERVENTIONS 1. Radiation therapy: For localized intrathoracic lung cancers and for palliation of hemoptysis, obstructions, dysphagia and pain 2. Chemotherapy 3. Immunotherapy directed at enhancing an effective immune response which favorably affects the course of the disease
6. SURGICAL INTERVENTIONS 1. Laser therapy: To relieve endobrachial obstruction 2. Thoracentesisand pleurodesis: To remove pleural fluid and relieve hypoxia 3. Thoracotomy with pneuomonectomy: Surgical removal of a lung
7. 4. Thoracotomy with lobectomy: Surgical removal of one lobe of the lung for tumors confined to a single lobe 5. Thoracotomywith segmental resections: Surgical removal of a lobe segment with clients unable to tolerate lobectomy
8. PREOP INTERVENTIONS Explain the potential post-op need for chest tubes Note that closed chest drainage usually is not used for apneuomonectomy, and the serum fluid that accumulates in the empty thoracic cavity eventually consolidates, preventing shifts of the mediastinum, heart and remaining lung
9. POST-OP INTERVENTIONS Monitor vital signs Assess cardiac and respiratory status, monitor for the absence and presence of lung sounds Maintain chest tube drainage system, which will drain air and blood that accumulates in the pleural space
10. Assess chest tube insertion site for crepitus, (subcutaneous emphysema) and drainage Administer O2 as prescribed Check physicians orders regarding client positions; avoid complete lateral turning
11. Monitor pulse oximetry Provide activity as tolerated Encourage active range–of–motion exercises of the operative shoulder as prescribed
12. Work Cited Silvestri, L. A. (2005). Saunder’s comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier Saunders
