COPD & Respiratory Tract Malignancies Flash Cards

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Title: COPD & Respiratory Tract Malignancies
Description: Lecture 3 -- 09/03/01
Number of Cards: 17
Save Count: 1
Author: scrapmom2four9
Created: 2001-10-18
Tags: medicine
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    • Question
    • Answer
    • Side 3
    • Complications of interventions for lung cancer
    • *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
    • *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
    • *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
    • *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
    • *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
    • *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
    • *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
    • *maximize quality of life, minimize complications
      *teach how to breathe, so not SOB
      *pulm rehab
    • Cancer of the larynx
    • *supraglottis (includes epiglottis)
      *glottis (2/3 of all cancers)
      *subglottis
    • Nursing Assessment
    • *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
    • *History & exam
      *CXR & barium swallow
      *MRI
      *laryngoscopy
      *pandendoscopy (views larynx, esophagus, trachea & bronchi)
    • Treatment of Ca of larynx
    • *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
    • *consent
      *normal bloodwork
      *how pt will communicate afterward
    • Post-op: CA of larynx
    • *maintain airway
      *remove secretions
      *relieve pain
      *communication
      *complications: bleeding, infect, resp. complications
      *esophageal speech, electronic larynx, TEP
    • Diagnostics for lung cancer
    • *CXR
      *Chest CT
      *cytological examination-2 ways (bronchoscopy, sputum culture)
      *bronchoscopy
      *bone scan
      *liver scan
      *head CT
    • Nursing assessments of COPD
    • *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
    • *Looking for cough patterns, wheezing, chest tightnes, hemoptysis, blood tinged sputum, dyspnea, hoarseness
      *factors ^ risk: smoking
      *nsg dx?