NURSING DIAGNOSIS & INTERVENTIONS

Esther Kamau

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

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

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

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

SURGICAL INTERVENTIONS

1. Laser therapy: To relieve endobrachial obstruction

2. Thoracentesis and pleurodesis: To remove pleural fluid and relieve hypoxia

3. Thoracotomy with pneuomonectomy: Surgical removal of a lung

4. Thoracotomy with lobectomy: Surgical removal of one lobe of the lung for tumors confined to a single lobe

5. Thoracotomy with segmental resections: Surgical removal of a lobe segment with clients unable to tolerate lobectomy

PREOP INTERVENTIONS

Explain the potential post-op need for chest tubes

Note that closed chest drainage usually is not used for a pneuomonectomy, and the serum fluid that accumulates in the empty thoracic cavity eventually consolidates, preventing shifts of the mediastinum, heart and remaining lung

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

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

Monitor pulse oximetry Provide activity as tolerated Encourage active range–of–motion

exercises of the operative shoulder as prescribed

Work Cited

Silvestri, L. A. (2005). Saunder’s comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier Saunders