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The leading cause of cancer death among men and women

Begins when cells in the lung grow out of control and form a tumor There are two main types of lung cancer: non-small cell and small cell

Precipitating Factors: Predisposing Factor: Genetics Diet Tobacco Use Lifestyle UV Exposure Other Carcinogens Environment Viruses

Cellular DNA mutation

Malignant Cellular Proliferation

Immune System Failure to destroy Cancer Cells

Malignant Cellular Survival

Malignant cellular Deprivation of Normal Cells of Nutrition and other substances for sustenance

Malignant Cellular Compression on Normal Cells

Normal Cell Death

C hanges in bladder or bowel habits A sore that fails to heal U unusual bleeding or discharges

T hickening of the lump


I ndigestion or difficulty swallowing O bvious changes in warts, moles or the skin N aging cough or hoarseness of voice U explained anemia S- udden loss of weight

Lung Cancer Staging


Staging is a way of describing a cancer, such as the size of the tumor and where it has spread
Staging is the most important tool doctors have to determine a patients prognosis The type of treatment a person receives depends on the stage of the cancer Staging is different for non-small cell lung cancer and small cell lung cancer

Stage I Non-Small Cell Lung Cancer


Cancer is found only in Cancer is found the lung Surgical removal recommended Radiation therapy and/or chemotherapy may also be used

Stage I Non-Small Cell Lung Cancer


TheCancer is found cancer has spread to lymph nodes in the lung Treatment is surgery to remove the tumor and nearby lymph nodes Chemotherapy recommended; radiation therapy sometimes given after chemotherapy

Stage I Non-Small Cell Lung Cancer


The cancer has spread to the lymph nodes located in the center of the chest, outside the lung Stage IIIA cancer has spread to lymph nodes in the chest, on the same side where the cancer originated Stage IIIB cancer has spread to lymph nodes on the opposite side of the chest, under the collarbone, or the pleura (lining of the chest cavity) Surgery or radiation therapy with chemotherapy recommended for stage IIIA Chemotherapy and sometimes radiation therapy recommended for stage IIIB

Cancer is found

The cancer has spread to different lobes of the lung or to other organs, such as the brain, bones, and liver Stage IV non-small cell lung cancer is treated with chemotherapy

Patients with limited stage (confined to one area of the chest) small cell lung cancer are treated with simultaneous radiation therapy and chemotherapy Patients with extensive stage (not confined to one area of the chest) small cell lung cancer are treated with chemotherapy only Because small cell lung cancer can spread to the brain, preventative radiation therapy to the brain is routinely recommended to all patients whose tumors disappear following chemotherapy and radiation therapy

Radiation Exposure Smoking Environmental/ Occupational Exposure -Asbestos -Radon -Passive smoke

Smoking Facts

Tobacco use is the leading cause of lung cancer 87% of lung cancers are related to smoking Risk related to: -age of smoking onset -amount smoked -gender -product smoked -depth of inhalation

Many symptoms of lung cancer affect the chest and air passages. These include: Persistent or intense coughing Pain in the chest shoulder, or back from coughing Changes in color of the mucus that is coughed up from the lower airways (sputum) Difficulty breathing and swallowing Hoarseness of the voiceMany symptoms of lung cancer affect the chest and air passages. These include: Persistent or intense coughing Pain in the chest shoulder, or back from coughing Changes in color of the mucus that is coughed up from the lower airways (sputum) Difficulty breathing and swallowing Hoarseness of the voice Harsh sounds while breathing (stridor) Chronic bronchitis or pneumonia Coughing up blood, or blood in the sputum Harsh sounds while breathing (stridor) Chronic bronchitis or pneumonia Coughing up blood, or blood in the sputum

As lung cancer cells spread and use more of the body's energy, it is possible to present symptoms that may also be associated with many other ailments. These include: Fever Fatigue Unexplained weight loss Pain in joints or bones Problems with brain function and memory Swelling in the neck or faceAs lung cancer cells spread and use more of the body's energy, it is possible to present symptoms that may also be associated with many other ailments. These include: Fever Fatigue Unexplained weight loss Pain in joints or bones Problems with brain function and memory Swelling in the neck or face General weakness Bleeding and blood clots General weakness Bleeding and blood clots

No tests are recommended for screening the general population A low-dose helical computerized tomography (CT or CAT) scan is currently being studied for this purpose Any person who is at increased risk due to smoking or asbestos exposure should discuss the benefits and limitations of a screening CT scan with his or her doctor

Treatment depends on the stage and type of lung cancer

Surgery
Radiation therapy

Chemotherapy (options include a combination of drugs)


Targeted therapy Lung cancer is usually treated with a combination of therapies

The tumor and the nearby lymph nodes in the chest are typically removed to offer the best chance for cure
For non-small cell lung cancer, a lobectomy (removal of the entire lobe where the tumor is located), has shown to be most effective Surgery may not be possible in some patients

Drugs used to kill cancer cells A combination of medications is often used May be prescribed before or after surgery, or before, during, or after radiation therapy Can improve survival and lessen lung cancer symptoms in all patients, even those with widespread lung cancer

The use of high-energy x-rays or other particles to destroy cancer cells


Side effects include fatigue, malaise (feeling unwell), loss of appetite, and skin irritation at the treatment site Radiation pneumonitis is the irritation and inflammation of the lung; occurs in 15% of patients It is important that the radiation treatments avoid the healthy parts of the lung

Assessment Subjective:

Nursing Diagnosis

Goal Expresses an understa nding of the need to balance rest and activity by the end of the shift.

Desired Outcome Demonstrat ea decrease in physiologic al signs of intolerance.

Intervention
Note presence of factors contributing to fatigue.

Rationale
Fatigue affects both the clients actual and perceived ability to participate in activities. Example: Stress and/or depression may be increasing the effects of an illness, or depression might be the result of forced inactivity.

Evaluatio n After 8 hours of rendering nursing interventi on, the client was able to: Balance the oxygen and demand and decrease the signs of intoleranc e.

Activity intolerance Daw gina related to kapoy ako, imbalance nabudlayan ko between mag ginhawa oxygen supply and demand. Objective: Adventitious breath sounds Dyspnea RR= 24 cpm CR= 61 ABG result: Metabolic acidosis

Assess emotional and psychological factors affecting the current situation.

Assessment

Nursing Diagnosis

Goal

Desired Outcome

Interventio n
Evaluate clients actual and perceived limitations, and severity of deficit in light of usual status.

Rationale

Evaluation

Provide comparative baseline and information about needed education or interventions regarding quality life.

Monitor vital and cognitive signs, watching for changes in blood pressure, heart and respiratory rate.