MindMap Gallery Lung cancer (1) mind map
Lung cancer mostly originates from the bronchial mucosal epithelium, also known as bronchial lung cancer. The age of onset is mostly over 40 years old. It is more common in men and ranks first among malignant tumors.
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lung cancer
Concept: Most of them originate from the bronchial mucosal epithelium, also known as bronchial lung cancer. Most of them are over 40 years old. It is more common in men and ranks first among malignant tumors.
Pathophysiology and classification
non-small cell carcinoma
Adenocarcinoma is more common in women, mostly peripheral type, generally grows slowly, and is the least sensitive to radiotherapy and chemotherapy.
Squamous cell carcinoma is closely related to smoking. Males predominate. It is often central lung cancer and is more sensitive to radiotherapy and chemotherapy.
Large cell carcinoma, rare, related to smoking, poorly differentiated, and poor prognosis
Small cell carcinoma is more common in elderly men, and central type is more common. Low degree of differentiation and high degree of malignancy Sensitivity to radiotherapy and chemotherapy
clinical manifestations
Early symptoms
Cough: The most common, irritating dry cough or a small amount of sticky sputum, ineffective in anti-infection, and a high-pitched metallic sound.
Bloody sputum: Central type is more common, with blood spots and blood streaks in the sputum, and intermittent small amounts of hemoptysis.
Chest pain: Tumor invasion of the pleura, chest wall, and ribs may cause irregular dull pain or dull pain in the chest.
Chest tightness and fever: cancer causes varying degrees of obstruction of larger bronchial tubes
Late symptoms
Violation of recurrent laryngeal nerve → hoarseness
Invasion of the superior vena cava → superior vena cava compression syndrome
Violation of the pleura and chest wall → chest pain and pleural effusion
Compression of the sympathetic nerve → ptosis of the upper eyelid on the same side, miosis of the pupil, enophthalmos, no sweating on the face, etc.
Symptoms of distant metastasis of tumors
Brain: increased intracranial pressure, cerebral herniation
Bone: local pain and tenderness, fracture
Liver: pain in liver area, jaundice, ascites, loss of appetite
Lymph nodes: swollen lymph nodes
Non-metastatic systemic symptoms: clubbing, osteoarthritis, Cushing syndrome, myasthenia gravis, gynecomastia
Auxiliary inspection
Sputum cytology
Film degree exam
fiberoptic bronchoscopy
Processing principles
Surgical treatment: lung resection, lymph node dissection
Purpose: Complete removal of primary lung cancer lesions and local and mediastinal lymph nodes. Suitable for patients with small lesions and no distant metastasis
Radiotherapy: Small cell carcinoma is more sensitive, followed by squamous cell carcinoma, and adenocarcinoma is the worst.
chemotherapy
Targeted therapy
Traditional Chinese Medicine Treatment
immunity therapy
Nursing diagnosis
Impaired gas exchange
malnutrition
pain
Anxiety and Fear
potential complications
Nursing measures
Preoperative preparation
airway preparation
Quit smoking for more than 2 weeks
Keep airway open
control infection
Guide respiratory function training
Nutritional support to reduce anxiety
Postoperative care
Condition observation
Postoperative 24h-48h ECG monitoring
Is there any respiratory distress?
BP, observe the temperature of the lips, extremities, and peripheral vein filling conditions
Suitable posture
Those who are not awake from anesthesia: supine position, head tilted to one side
Awake person with stable blood pressure: semi-sitting and recumbent position
For patients undergoing segmental or wedge resection: lying on the healthy side
Poor respiratory function: supine position
Patients undergoing pneumonectomy: 1/4 lateral position
Patients with bloody sputum and bronchial fistula: lying on the affected side
Keep airway open
Give oxygen
Observe breathing
Encourage and assist deep breathing and coughing
thin sputum
Chest closed drainage care
Closely observe the volume, color and properties of drainage fluid
Continuous negative pressure suction care: 24 hours after surgery
After pneumonectomy: the volume of fluid injected each time should not exceed 100ml
maintain fluid balance
Strictly control the infusion rate: 20-30 drops/min
Nutritional supplements
Activities and rest
Complication care
Intrathoracic bleeding: speed up the infusion, give hemostatic drugs, and keep the chest drainage tube open
Pneumonia and atelectasis: focus on prevention, guide deep breathing, effective coughing and sputum suction
Arrhythmia: occurs within 4 days after surgery. Use antiarrhythmic drugs as directed by your doctor.
Bronchopleural fistula: Place the patient in the affected side decubitus position 3-14 days after surgery, and use antibiotics to prevent infection.
Pulmonary edema: Immediately slow down the infusion rate and give oxygen
Pulmonary embolism: bed rest, oxygen inhalation, controlled infusion rate, anti-shock, anticoagulation, thrombolytic treatment
Myocardial infarction: Bed rest, oxygen inhalation, ECG monitoring and psychological care, analgesia, anti-arrhythmia, anti-shock and other treatments as prescribed by the doctor