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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Deficient Knowledge

Nursing Diagnosis

May be related to

  • Lack of exposure, unfamiliarity with information/resources
  • Information misinterpretation
  • Lack of recall

Possibly evidenced by

  • Statements of concern; request for information
  • Inadequate follow-through of instruction
  • Inappropriate or exaggerated behaviors, e.g., hysterical, hostile, agitated, apathetic

Desired Outcomes

  • Verbalize understanding of ramifications of diagnosis, prognosis, possible complications.
  • Participate in the learning process.
  • Verbalize understanding of therapeutic regimen.
  • Correctly perform necessary procedures and explain the reasons for the actions.
  • Initiate necessary lifestyle changes.
Nursing Interventions Rationale
Discuss diagnosis, current and/or planned therapies, and expected outcomes. Provides individually specific information, creating a knowledge base for subsequent learning regarding home management. Radiation or chemotherapy may follow surgical intervention, and information is essential to enable the patient or SO to make informed decisions.
Reinforce the surgeon’s explanation of the particular surgical procedure, providing a diagram as appropriate. Incorporate this information into the discussion about short or long-term recovery expectations. Length of rehabilitation and prognosis depend on the type of surgical procedure, preoperative physical condition, and duration or degree of complications.
Discuss the necessity of planning for follow-up care before discharge. Follow-up assessment of respiratory status and general health is imperative to assure optimal recovery. Also provides an opportunity to readdress concerns/ questions at a less stressful time.
Identify signs and symptoms requiring medical evaluations, e.g., changes in the appearance of incision, development of respiratory difficulty, fever, increased chest pain, changes in the appearance of sputum. Early detection and timely intervention may prevent/ minimize complications.
Help the patient determine activity tolerance and set goals. Weakness and fatigue should decrease as lung(s) heals and respiratory function improves during the recovery period, especially if cancer was completely removed. If cancer is advanced, it is emotionally helpful for the patient to be able to set realistic activity goals to achieve optimal independence.
Provide appropriate care before surgery: 
  • If the patient is to undergo surgery, supplement or reinforce the information given by the healthcare team about the disease and the surgical procedure.
Can help allay anxiety and provides an opportunity to discuss fears or concerns.
  • Explain expected postoperative procedures, such as insertion of an indwelling catheter, use of an endotracheal tube or chest tube, dressing changes, and IV therapy.
Health teaching is more effective before surgery when the patient is conscious and aware.
Teach the patient how to perform deep breathing, coughing, and ROM exercises. Helpful in immediately maximizing lung volume after surgery.
Evaluate availability or adequacy of support system(s) and the necessity for assistance in self-care or home management. General weakness and activity limitations may reduce an individual’s ability to meet own needs.
Recommend alternating rest periods with activity and light tasks with heavy tasks. Stress avoidance of heavy lifting, isometric or strenuous upper body exercise. Reinforce physician’s time limitations about lifting. Generalized weakness and fatigue are usual in the early recovery period but should diminish as respiratory function improves and healing progresses. Rest and sleep enhance coping abilities, reduce nervousness (common in this phase), and promote healing. Strenuous use of arms can place undue stress on incision because chest muscles may be weaker than normal for 3–6 months following surgery.
Recommend stopping any activity that causes undue fatigue or increased shortness of breath. Exhaustion aggravates respiratory insufficiency.
Encourage inspection of incisions. Review expectations for healing with the patient. Healing begins immediately, but complete healing takes time. As healing progresses, incision lines may appear dry, with crusty scabs. Underlying tissue may look bruised and feel tense, warm, and lumpy (resolving hematoma).
Instruct patient or SO to watch for and report places in incision that do not heal or reopening of healed incision, any drainage (bloody or purulent), localized area of swelling with redness or increased pain that is hot to touch. Signs and symptoms indicating a failure to heal, development of complications requiring further medical evaluation or intervention.
Suggest wearing soft cotton shirts and loose-fitting clothing, cover or pad portion of the incision as indicated, leave the incision open to air as much as possible. Reduces suture line irritation and pressure from clothing. Leaving incisions open to air promotes healing process and may reduce the risk of infection.
Shower in warm water, washing incision gently. Avoid tub baths until approved by physician. Keeps incision clean, promotes circulation or healing. Climbing out of tub requires the use of arms and pectoral muscles, which can put undue stress on the incision.
Support incision with Steri-Strips as needed when sutures or staples are removed. Aids in maintaining approximation of wound edges to promote healing.
Provide rationale for arm and shoulder exercises. Have patient/SO demonstrate exercises. Encourage following a graded increase in number and/or intensity of routine repetitions. Simple arm circles and lifting arms over the head or out to the affected side are initiated on the first or second postoperative day to restore normal range of motion (ROM) of shoulder and to prevent ankylosis of the affected shoulder.
Stress importance of avoiding exposure to smoke, air pollution, and contact with individuals with URIs. Protects lung(s) from irritation and reduces the risk of infection.
Review nutritional and/or fluid needs. Suggest increasing protein and use of high-calorie snacks as appropriate. Meeting cellular energy requirements and maintaining good circulating volume for tissue perfusion facilitate tissue regeneration or healing process.
Identify individually appropriate community resources. Agencies such as these offer a broad range of services that can be tailored to provide support and meet individual needs.
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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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