Nursing Care Plan Lung Cancer (Postoperative Care)

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Inpatient surgical and possibly subacute units.


  1. Cancer
  2. Hemothorax/pneumothorax
  3. Psychosocial aspects of care
  4. Radical neck surgery: laryngectomy (postoperative care)
  5. Surgical intervention
  6. Patient Assessment Database (Preoperative)
  7. Findings depend on type, duration of cancer, and extent of metastasis.


May report: 
Fatigue, inability to maintain usual routine, dyspnea with activity

May exhibit: 
Lassitude (usually in advanced stage)


May exhibit: 
  1. Jugular venous distention (JVD) (with vena caval obstruction)
  2. Heart sounds: Pericardial rub (indicating effusion)
  3. Tachycardia/dysrhythmias
  4. Clubbing of fingers


May report: 
  1. Frightened feelings, fear of outcome of surgery
  2. Denial of severity of condition/potential for malignancy
  3. May exhibit: Restlessness, insomnia, repetitive questioning


May report: 
  1. Intermittent diarrhea (hormonal imbalance, SCLC)
  2. Increased frequency/amount of urine (hormonal imbalance, epidermoid tumor)


May report: 
  1. Weight loss, poor appetite, decreased food intake
  2. Difficulty swallowing
  3. Thirst/increased fluid intake

May exhibit: 
  1. Thin, emaciated, or wasted appearance (late stages)
  2. Edema of face/neck, chest, back (vena caval obstruction); facial/periorbital edema (hormonal imbalance, SCLC)
  3. Glucose in urine (hormonal imbalance, epidermoid tumor)


May report: 
  1. Chest pain (not usually present in early stages and not always in advanced stages), which may/may not be affected by position change
  2. Shoulder/arm pain (particularly with large cell or adenocarcinoma)
  3. Bone/joint pain: Cartilage erosion secondary to increased growth hormones (large cell carcinoma or adenocarcinoma)
  4. Intermittent abdominal pain

May exhibit: 
  1. Distraction behaviors (restlessness, withdrawal)
  2. Guarding/protective actions


May report: 
  1. Mild cough or change in usual cough pattern and/or sputum production
  2. Shortness of breath
  3. Occupational exposure to pollutants, industrial dusts (e.g., asbestos, iron oxides, coal dust), radioactive material
  4. Hoarseness/change in voice (vocal cord paralysis)
  5. History of smoking

May exhibit: 
  1. Dyspnea, aggravated by exertion
  2. Increased tactile fremitus (indicating consolidation)
  3. Brief crackles/wheezes on inspiration or expiration (impaired airflow)
  4. Persistent crackles/wheezes; tracheal shift (space-occupying lesion)
  5. Hemoptysis


May exhibit: 
  1. Fever may be present (large cell carcinoma or adenocarcinoma)
  2. Bruising, discoloration of skin (hormonal imbalance, SCLC)


May exhibit: 
  1. Gynecomastia (neoplastic hormonal changes, large cell carcinoma)
  2. Amenorrhea/impotence (hormonal imbalance, SCLC)


May report: 
  1. Familial risk factors: Cancer (especially lung), tuberculosis
  2. Failure to improve
  3. Discharge plan
  4. DRG projected mean length of inpatient stay: 9.9 days
  5. Assistance with transportation, medications, treatments, self-care, homemaker/maintenance tasks.
  6. Refer to section at end of plan for postdischarge considerations.


  1. Fiberoptic bronchoscopy: Allows for direct visualization, regional washings, and cytologic brushing of lesions (large percentage of bronchogenic carcinomas may be visualized).
  2. Chest x-ray (PA[posteroanterior] and lateral), chest computed tomography (CT): Outlines shape, size, and location of lesion. May reveal mass of air in hilar region, pleural effusion, atelectasis, or erosion of ribs or vertebrae.
  3. Positron emission tomography (PET): Useful diagnostic tool in early detection of cancer, allowing measurement of differential metabolic activity in normal and diseased tissues.
  4. Magnetic resonance imaging (MRI) scan: May be used in combination or instead of CT scans to determine tumor size/location and for staging.
  5. Cytologic examinations (sputum, pleural, or lymph node): Performed to assess presence/stage of carcinoma, and may identify tumors of the bronchial wall.
  6. Needle or tissue biopsy: May be performed on scalene nodes, hilar lymph nodes, or pleura to establish diagnosis.
  7. Mediastinoscopy: Used for staging of carcinoma and to examine for metastasis.
  8. Pulmonary function studies and ABGs: Assess lung capacity to meet postoperative ventilatory needs.
  9. Skin tests, absolute lymphocyte counts: May be done to evaluate for immunocompetence (common in lung cancers).
  10. Bone scan; CT scan of brain, liver; gallium scan of liver, spleen, bone: Used to detect metastasis.


  1. Maintain/improve respiratory function.
  2. Control/alleviate pain.
  3. Support efforts to cope with diagnosis/situation.
  4. Provide information about disease process/prognosis and therapeutic regimen.


  1. Oxygenation/ventilation adequate to meet individual activity needs.
  2. Pain controlled.
  3. Anxiety/fear decreased to manageable level.
  4. Free of preventable complications.
  5. Disease process/prognosis and planned therapies understood.
  6. Plan in place to meet needs after discharge.

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Caty Karther mengatakan...

This nursing plan is for all of the lung cancer patients. As this lung cancer is increasing at very high rate therefore this plan can be very useful for all the patients if they follow it.

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