lOMoARcPSD|26582732
Mid term study guide for Surgical
Treatment for Non-Small Cell Lung Cancer
Overview of Surgical Options (00:00:00 - 00:00:33)
● Surgery can be a curative option for patients with stage 1 or 2 non-small cell lung
cancer.
● The specific surgical procedure depends on the stage, location of the tumor, and overall
health of the patient.
● Possible surgical procedures include:
0 Removing just the tumor
○ Removing part of the lung (lobectomy)
○ Removing the entire lung (pneumonectomy)
○ Removing a segment of the lung (segmental resection)
○ Removing a small, localized tumor (wedge resection)
Pre-Operative Education (00:00:44 - 00:01:06)
● Patients need to understand the surgical procedure they will undergo.
● They should be informed about what to expect in the post-operative period, such as:
0 Whether they will be in the ICU
○ If they will have chest tubes
○ How long they will be hospitalized
○ If they will be on a ventilator
Surgical Approaches (00:01:44 - 00:02:52)
● Thoracotomy is a more invasive surgical approach with larger incisions.
0 Longer hospital stay
○ Higher risk of infection
○ Longer healing time
● Preferred Surgical Approach: Video-assisted thoracoscopic surgery (VATS) is a
minimally invasive approach.
0 Smaller incisions
○ Shorter hospital stay
○ Lower risk of infection
○ Less post-operative pain
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Post-Operative Care (00:03:02 - 00:05:10)
● Patients who undergo thoracotomy are more likely to go to the ICU and have multiple
chest tubes.
● Chest tubes are used to drain air, blood, and fluid from the pleural space to allow the
lung to re-expand.
● Patients will likely require pain medication, including patient-controlled analgesia (PCA).
● Monitoring vital signs is important, as the patient is on narcotics.
● Incentive spirometry is crucial to prevent complications like pneumonia.
Chest Drainage System (00:05:10 - 00:09:53)
Components
● Chest tube inserted into the pleural cavity
● 6-ft tubing connecting the chest tube to the drainage system ● Drainage collection
chamber (e.g., Pleurovac)
0 Allows for measurement of drainage
volume ● Water seal chamber
○ Allows air to leave the chest but prevents air from entering
● Suction chamber
0 Connects to wall suction to facilitate
quicker healing
Monitoring the Drainage System
● Avoid knocking over the drainage system to maintain a closed system and prevent
infection.
● Observe for "tidying" (fluctuation of the water level in the water seal chamber) - this is
normal.
● Observe for excessive bubbling in the water seal chamber, which may indicate an air
leak.
Caring for Patients with Chest Tubes and
Pleural Effusions
Assessing Chest Tube Function (00:10:38 - 00:10:49)
● Perform a cough test to check for air leaks
● Observe for "bubbling" in the chest tube, which indicates a minor leak
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Monitoring Chest Tube Patients (00:10:49 - 00:11:30)
● Excessive bubbling is abnormal and should be investigated
● Patients who have had thoracotomy or VATS procedures often require one or more
chest tubes
● The number and necessity of chest tubes depends on the extent of the surgical
procedure
Removing Chest Tubes (00:11:54 - 00:12:36)
● Chest tubes are typically removed by the healthcare provider, not the nurse
● Ensure the dressing around the chest tube is intact to prevent air leaks ● If the tube
appears to have come out, remove the dressing and assess the site
Nursing Care for Chest Tube Patients (00:12:51 -
00:14:23)
● Airway management and ventilation assessment are priorities
● Monitor oxygen saturation, respiratory pattern, and tracheal deviation
● Auscultate breath sounds, noting any absence on the surgical side
● Assess for peripheral or central cyanosis
● Encourage incentive spirometry, coughing, and early mobility
● Monitor the surgical incision for signs of infection
Pleural Effusions (00:15:31 - 00:16:44)
● Pleural effusions are a common complication in lung cancer patients
● Fluid accumulates in the pleural space, causing shortness of breath ● Thoracentesis
is often performed to remove the fluid, but it may reaccumulate
Performing Thoracentesis (00:16:44 - 00:19:29)
● The patient is positioned sitting or lying with the arm elevated
● The skin is numbed, and a needle is inserted into the pleural space to drain the fluid
● Complications to monitor for include pneumothorax, bleeding, and infection
● Thoracentesis can be done intermittently or with a permanent catheter for ongoing
drainage
Post-Thoracentesis Care (00:19:29 - 00:20:13)
Downloaded by NELSON KIIRU ()
Mid term study guide for Surgical
Treatment for Non-Small Cell Lung Cancer
Overview of Surgical Options (00:00:00 - 00:00:33)
● Surgery can be a curative option for patients with stage 1 or 2 non-small cell lung
cancer.
● The specific surgical procedure depends on the stage, location of the tumor, and overall
health of the patient.
● Possible surgical procedures include:
0 Removing just the tumor
○ Removing part of the lung (lobectomy)
○ Removing the entire lung (pneumonectomy)
○ Removing a segment of the lung (segmental resection)
○ Removing a small, localized tumor (wedge resection)
Pre-Operative Education (00:00:44 - 00:01:06)
● Patients need to understand the surgical procedure they will undergo.
● They should be informed about what to expect in the post-operative period, such as:
0 Whether they will be in the ICU
○ If they will have chest tubes
○ How long they will be hospitalized
○ If they will be on a ventilator
Surgical Approaches (00:01:44 - 00:02:52)
● Thoracotomy is a more invasive surgical approach with larger incisions.
0 Longer hospital stay
○ Higher risk of infection
○ Longer healing time
● Preferred Surgical Approach: Video-assisted thoracoscopic surgery (VATS) is a
minimally invasive approach.
0 Smaller incisions
○ Shorter hospital stay
○ Lower risk of infection
○ Less post-operative pain
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Post-Operative Care (00:03:02 - 00:05:10)
● Patients who undergo thoracotomy are more likely to go to the ICU and have multiple
chest tubes.
● Chest tubes are used to drain air, blood, and fluid from the pleural space to allow the
lung to re-expand.
● Patients will likely require pain medication, including patient-controlled analgesia (PCA).
● Monitoring vital signs is important, as the patient is on narcotics.
● Incentive spirometry is crucial to prevent complications like pneumonia.
Chest Drainage System (00:05:10 - 00:09:53)
Components
● Chest tube inserted into the pleural cavity
● 6-ft tubing connecting the chest tube to the drainage system ● Drainage collection
chamber (e.g., Pleurovac)
0 Allows for measurement of drainage
volume ● Water seal chamber
○ Allows air to leave the chest but prevents air from entering
● Suction chamber
0 Connects to wall suction to facilitate
quicker healing
Monitoring the Drainage System
● Avoid knocking over the drainage system to maintain a closed system and prevent
infection.
● Observe for "tidying" (fluctuation of the water level in the water seal chamber) - this is
normal.
● Observe for excessive bubbling in the water seal chamber, which may indicate an air
leak.
Caring for Patients with Chest Tubes and
Pleural Effusions
Assessing Chest Tube Function (00:10:38 - 00:10:49)
● Perform a cough test to check for air leaks
● Observe for "bubbling" in the chest tube, which indicates a minor leak
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Monitoring Chest Tube Patients (00:10:49 - 00:11:30)
● Excessive bubbling is abnormal and should be investigated
● Patients who have had thoracotomy or VATS procedures often require one or more
chest tubes
● The number and necessity of chest tubes depends on the extent of the surgical
procedure
Removing Chest Tubes (00:11:54 - 00:12:36)
● Chest tubes are typically removed by the healthcare provider, not the nurse
● Ensure the dressing around the chest tube is intact to prevent air leaks ● If the tube
appears to have come out, remove the dressing and assess the site
Nursing Care for Chest Tube Patients (00:12:51 -
00:14:23)
● Airway management and ventilation assessment are priorities
● Monitor oxygen saturation, respiratory pattern, and tracheal deviation
● Auscultate breath sounds, noting any absence on the surgical side
● Assess for peripheral or central cyanosis
● Encourage incentive spirometry, coughing, and early mobility
● Monitor the surgical incision for signs of infection
Pleural Effusions (00:15:31 - 00:16:44)
● Pleural effusions are a common complication in lung cancer patients
● Fluid accumulates in the pleural space, causing shortness of breath ● Thoracentesis
is often performed to remove the fluid, but it may reaccumulate
Performing Thoracentesis (00:16:44 - 00:19:29)
● The patient is positioned sitting or lying with the arm elevated
● The skin is numbed, and a needle is inserted into the pleural space to drain the fluid
● Complications to monitor for include pneumothorax, bleeding, and infection
● Thoracentesis can be done intermittently or with a permanent catheter for ongoing
drainage
Post-Thoracentesis Care (00:19:29 - 00:20:13)
Downloaded by NELSON KIIRU ()
