OCCUPATIONAL LUNG DISEASE, LUNG CANCER

Question 1

INTERSTITIAL LUNG DISEASE

SARCOIDOSIS

Answer 1

can effect any organ but the lungs are the primary target

Question 2

SARCOIDOSIS PATHOPHYSIOLOGY

Answer 2

• Hypersensitivity response to one or more exogenous agents
• connective tissue disorder
• Granuloma infiltration (build up of cells) and fibrosis may occur
  — low lung compliance (Pts cant get deep breath)
  — Impaired diffusing capacity
  — Reduced lung volumes

Question 3

SARCOIDOSIS CLINICAL MANIFESTATIONS

Answer 3

• Dyspnea
• Cough
• Hemoptysis
• Congestion

Question 4

SARCOIDOSIS ASSESSMENT AND DIAGNOSTIC FINDINGS

Answer 4

Chest x-ray
CT scan
Mediastinoscopy or transbronchial biopsy
Pulmonary function tests

Question 5

SARCOIDOSIS MEDICAL MANAGEMENT

Answer 5

Oral corticosteroids/ for inflammation

Question 6

OCCUPATIONAL LUNG DISEASE
PNEUMOCONIOSES

Answer 6

• Occupational lung disease and includes asbestosis, silicosis, and coal workers’ pneumoconiosis (aka “Black Lung Disease”)
• Refers to a non-neoplastic (non cancerous) alteration of the lung resulting from inhalation of mineral or inorganic dust
• Preventable, not treatable
• Reduce exposure, protective gear/devices
• Role of nurse is to be the employee advocate and provide health education on preventive measures to reduce lung injury
• Refer to Table 23-5, page 620

Question 7

LUNG CANCER

Answer 7

• Leading cause of death in the United States
• > 85% caused by cigarette smoke (non small cell)
• Classification: 15% SCLC and 85% NSCLC tumors

Question 8

LUNG CANCER Treatment

Answer 8

• Surgery, refer to Chart 23-13, top of page 623
• Radiation
• Chemotherapy

Question 9

LUNG CANCER RISK FACTORS

Answer 9

• Environmental factors
• Genetic predisposition
• Dietary deficits
• Respiratory disease ie. COPD and TB
• Familial predisposition

Question 10

LUNG CANCER CLINICAL MANIFESTATIONS

Answer 10

• Change in cough or chronic cough
• Dyspnea
• Hemoptysis
• Chest or shoulder pain
• Recurring low grade fever

Question 11

LUNG CANCER ASSESSMENT AND DIAGNOSTIC FINDINGS

Answer 11

• Chest x-ray
• CT scan
• Fiberoptic bronchoscopy
• Transthoracic fine-needle aspiration

Question 12

LUNG CANCER MEDICAL MANAGEMENT

Answer 12

Treatment:
- Surgery: small cell only in one lung w/ no metastasis
— do medialstienoscopy, then do fluoroscopy, then do surgery:
—- lobectopy/ wedge resection, pnumonectomy (1 whole lung),
- Radiation
- Chemotherapy

Question 13

NURSING CARE OF THE PATIENT WITH CANCER

Answer 13

• Airway clearance
• Dyspnea
• Fatigue
• Pain
• Psychological support

Question 14

THORACIC SURGERY

Answer 14

Procedures to relieve conditions:
- Lung abscesses
- Lung cancer
- Cysts
- Benign tumors
- Emphysema

Question 15

Lung cancer PREOPERATIVE MANAGEMENT

Answer 15

• Assessment and diagnosis
• Improving airway clearance
• Educating the patient: splint: hug pillow when coughing, may have chest tube
• Relieving anxiety

Question 16

Lung cancer POSTOPERATIVE MANAGEMENT

Answer 16

• Vital signs checked frequently
• Oxygen
• Careful positioning: chest tubes hurt (pad w/ pillow if turning on effective side)
• Medication for pain
• Mechanical ventilation
• Chest drainage

Question 17

POSTOPERATIVE NURSING MANAGEMENT- THORACIC SURGERY

Answer 17

• Monitoring respiratory and cardiovascular status (circulation)
• Improving gas exchange and breathing
• Improving airway clearance
• Relieving pain and discomfort
• Promoting mobility and shoulder exercises
• Maintaining fluid volume and nutrition
• Monitoring and managing potential complications
  — anticoagulant after first day
  — SCD
  — early ambulation
  —

Question 18

Cancer chemo precautions:

Answer 18

• PPE: mask, 2x gloved, splash guard (in case chemo splashes up)
  Nutrapenic (WBC low)
• reverse isolation
  — no fresh fruits, flowers, yogurt, shit like that