5 Lung Cancer Nursing Care Plans

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Lung cancer is the most common cause of cancer death in men and women. Lung cancer is the carcinoma of the lungs characterized by uncontrolled growth of tissues of the lung. It usually develops within the wall or epithelium of the bronchial tree. Its most common types are epidermoid (squamous cell) carcinoma, small cell (oat cell) carcinoma, adenocarcinoma, and large cell (anaplastic) carcinoma. Although the prognosis is usually poor, it varies with the extent of metastasis at the time of diagnosis and the cell type growth rate. Only about 13% of patients with lung cancer survive 5 years after diagnosis.

Lung cancer is mostly attributable to inhalation of carcinogenic pollutants by a susceptible host. Any smoker older than 40, especially if the person began to smoke before age 15, has smoked a whole pack or more per day for 20 years, or works with or near asbestos. Pollutants in tobacco smoke cause progressive lung cell degeneration. Lung cancer is 10 times more common in smokers than in nonsmokers. Cancer risk is determined by the number of cigarettes smoked daily, the depth of inhalation, how early in life smoking began, and the nicotine content of cigarettes.

Nursing Care Plans

Nursing care for patients with lung cancer revolves around comprehensive supportive care and patient teaching can minimize complications and speed recovery from surgery, radiation and/or chemotherapy.

Here are five (5) lung cancer nursing care plans (NCP) and nursing diagnosis:

  1. Impaired Gas Exchange
  2. Ineffective Airway Clearance
  3. Acute Pain
  4. Fear/Anxiety
  5. Deficient Knowledge
  6. Other Nursing Diagnoses
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Ineffective Airway Clearance

Nursing Diagnosis

May be related to

  • Increased amount/viscosity of secretions
  • Restricted chest movement/pain
  • Fatigue/weakness

Possibly evidenced by

  • Changes in rate/depth of respiration
  • Abnormal breath sounds
  • Ineffective cough
  • Dyspnea

Desired Outcomes

  • Demonstrate patent airway, with fluid secretions easily expectorated, clear breath sounds, and noiseless respirations.
Nursing Interventions Rationale
Auscultate chest for character of breath sounds and presence of secretions. Noisy respirations, rhonchi, and wheezes are indicative of retained secretions and/or airway obstruction.
Assist patient and instruct effective deep breathing and coughing with upright position (sitting) and splinting of an incision. Upright position favors maximal lung expansion and splinting improves the force of cough effort to mobilize and remove secretions. Splinting may be done by the nurse (placing hands anteriorly and posteriorly over chest wall) and by the patient (with pillows) as strength improves.
Observe the amount and character of sputum or aspirated secretions. Investigate changes as indicated. Increased amounts of colorless, blood-streaked, or watery secretions are normal initially and should decrease as recovery progresses. Presence of thick or tenacious, bloody, or purulent sputum suggests the development of secondary problems (dehydration, pulmonary edema, local hemorrhage, or infection) that require correction and treatment.
Suction if cough is weak or breath sounds not cleared by cough effort. Avoid deep endotracheal or nasotracheal suctioning in pneumonectomy patient if possible. Suction the patient as needed, and encourage to begin deep breathing and coughing as soon as possible. “Routine” suctioning increases risk of hypoxemia and mucosal damage. Deep tracheal suctioning is generally contraindicated following pneumonectomy to reduce the risk of rupture of the bronchial stump suture line. If suctioning is unavoidable, it should be done gently and only to induce effective coughing.
Encourage oral fluid intake (at least 2500 mL/day) within cardiac tolerance. Adequate hydration aids in keeping secretions loose or enhances expectoration.
Assess for pain or discomfort and medicate on a routine basis and before breathing exercises. Encourages patient to move, cough more effectively, and breathe more deeply to prevent respiratory insufficiency.
Assist with incentive spirometer, postural drainage and percussion as indicated. Improves lung expansion or ventilation and facilitates removal of secretions. Postural drainage may be contraindicated in some patients and in any event, must be performed cautiously to prevent respiratory embarrassment and incisional discomfort.
Use humidified oxygen and/or ultrasonic nebulizer. Provide additional fluids via IV as indicated. Providing maximal hydration helps loosen or liquefy secretions to promote expectoration. Impaired oral intake necessitates IV supplementation to maintain hydration.
Administer bronchodilators, expectorants, and/or analgesics as indicated. Relieves bronchospasm to improve airflow. Expectorants increase mucus production and liquefy and reduce the viscosity of secretions, facilitating removal. Alleviation of chest discomfort promotes cooperation with breathing exercises and enhances the effectiveness of respiratory therapies.
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See Also

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Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

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