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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Acute Pain

Nursing Diagnosis

May be related to

  • Surgical incision, tissue trauma, and disruption of intercostal nerves
  • Presence of chest tube(s)
  • Cancer invasion of pleura, chest wall

Possibly evidenced by

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  • Verbal reports of discomfort
  • Guarding of affected area
  • Distraction behaviors, e.g., restlessness
  • Narrowed focus (withdrawal)
  • Changes in BP, heart/respiratory rate

Desired Outcomes

  • Report pain relieved/controlled.
  • Appear relaxed and sleep/rest appropriately.
  • Participate in desired/needed activities.
Nursing Interventions Rationale
Ask the patient about pain. Determine pain characteristics: continuous, aching, stabbing, burning. Have patient rate intensity on a 0–10 scale. Helpful in evaluating cancer-related pain symptoms, which may involve viscera, nerve, or bone tissue. Use of rating scale aids the patient in assessing the level of pain and provides a tool for evaluating the effectiveness of analgesics, enhancing patient control of pain.
Assess patient’s verbal and nonverbal pain cues. The discrepancy between verbal and/or nonverbal cues may provide clues to the degree of pain, need for or effectiveness of interventions.
Note possible pathophysiological and psychological causes of pain. Fear, distress, anxiety, and grief over the confirmed diagnosis of cancer can impair the ability to cope. In addition, a posterolateral incision is more uncomfortable for the patient than an anterolateral incision. The presence of chest tubes can greatly increase discomfort.
Evaluate effectiveness of pain control. Encourage sufficient medication to manage pain; change medication or time span as appropriate. Pain perception and pain relief are subjective, thus pain management is best left to the patient’s discretion. If the patient is unable to provide input, the nurse should observe physiological and nonverbal signs of pain and administer medications on a regular basis.
Encourage verbalization of feelings about the pain. Fears or concerns can increase muscle tension and lower threshold of pain perception.
Provide comfort measures: frequent changes of position, back rubs, support with pillows. Encourage use of relaxation techniques, visualization, guided imagery, and appropriate diversional activities. Promotes relaxation and redirects attention. Relieves discomfort and augments therapeutic effects of analgesia.
Schedule rest periods, provide quiet environment. Decreases fatigue and conserves energy, enhancing coping abilities.
Assist with self-care activities, breathing and/or arm exercises, and ambulation. Prevents undue fatigue and incisional strain. Encouragement and physical assistance and support may be needed for some time before the patient is able or confident enough to perform these activities because of pain or fear of pain.
Assist with patient-controlled analgesia (PCA) or analgesia through the epidural catheter. Administer intermittent analgesics routinely as indicated, especially 45–60 min before respiratory treatments, deep-breathing or coughing exercises. Maintaining a constant drug level avoids cyclic periods of pain, aids in muscle healing, and improves respiratory function and emotional comfort and coping.
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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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