Gas Exchange: O2 is transported to the cells and CO2 away from cells via the bloodstream.
Neurons in the brain sense need for gas exchange and stimulate contraction of the skeletal muscles expanding chest cavity and causing inhalation.
Oxygen diffuses from alveoli into blood and CO2 diffuses back into alveoli for exhalation.
Normal functioning brain, spinal cord, diaphragm, and skeletal muscle contractility are required for adequate gas exchange.
Intact Chest/Thorax with functioning alveoli and good blood flow in surrounding capillaries is necessary for adequate gas exchange.
Any respiratory problem can affect gas exchange which affects well-being and total body health.
Decreased Gas Exchange results in inadequate transportation of O2 to body cells (Hypoxia) which can lead to cell necrosis and death.
Hypercapnia results from the build up of CO2 which combines with H2O to produce carbonic acid, resulting in respiratory acidosis and acid base imbalance.
Intrapulmonary Shunt refers to perfusion without ventilation.
Dead-space refers to ventilation without perfusion.
The most common symptoms of lung cancer are a persistent cough that may be productive of blood tinged sputum, wheezing, chest pain, hoarseness, weight loss, and dyspnea.
Chemotherapy is an intervention used in the treatment of lung cancer, which involves drugs that work systemically to kill cancer cells.
Surgery is the treatment of choice in stage 1 or 2 lung cancer.
Bx (Biopsy) of cancer cells or plural fluid is definitive in the diagnosis of lung cancer.
Surgical interventions for lung cancer include wedge resection, segmental resection, pneumonectomy, and lobectomy.
Targeted therapy is an intervention used in the treatment of lung cancer, which involves drugs that work to disrupt cancer cell division.
Immunotherapy is an intervention used in the treatment of lung cancer, which involves drugs that allow for the patient's own immune system to better recognize and attack cancer cells.
Radiation is an intervention used in the treatment of lung cancer, which involves high-energy rays or particles targeted to kill cancer cells.
Diagnostics for lung cancer include chest x-ray, CT scan, sputum for cytological studies, bronchoscopy, mediastinoscopy, and interventions such as surgery, radiation, chemotherapy, targeted therapy, and immunotherapy.
Recognize cues in the patient history by considering areas of high pollution, highly populated areas, extremes in weather, aging increases risk.
Post-operative nursing care for laryngectomy patients includes maintaining patient airway by suctioning/keeping stoma clear, positioning midline/head of bed elevated, suture lines/stoma care, flap checks (if present), nutrition, and emotional support.
Diagnostic tests for laryngeal cancer include X-rays to determine metastasis, CT scan, MRI, and endoscopy to visualize and take biopsy of tumor to determine cancer cell type and stage.
Extensive traditional surgery is often required for laryngectomy, with partial laryngectomy when only one vocal cord or no vocal cords are removed, allowing for speaking and breathing normally, and total laryngectomy with radical neck dissection when the entire larynx/vocal cords are removed, resulting in a permanent stoma created in the neck and requiring an alternate method to talk.
Total laryngectomy can lead to changes in body image, depression, and altered lifestyle.
Recognizing cues for lung cancer can be challenging as symptoms are usually nonspecific and appear late in the disease process.
Treatment of laryngeal cancer depends on tumor type, size and location, patient and surgeon preference, and may involve radiation, chemo, biotherapy, laser surgery, surgery or any combination of these.
Voice restoration/voice rehabilitation in laryngectomy patients is challenging as the vocal cords are gone, and communication can be done using a pen/paper or communication board immediately post-operation.
Recognize cues in the patient history by considering respiratory health history such as smoking, vaping, drug use, travel, allergies.
Pulmonary Embolus is a condition where there is a blockage of Pulmonary vessels by a thrombus, which can be a solid, fatty deposit, or air.
Cardiac Dysrhythmias in COPD patients are related to decreased oxygenation of heart muscle, and can be exacerbated by anxiety.
Prevention of Exacerbations in COPD patients involves avoiding crowds, staying indoors when air quality is poor, and staying up to date on pneumonia and flu vaccines.
Treatment of Acute Exacerbation in COPD patients will require hospitalization and increased monitored care, and may involve increased inhaled bronchodilators, antibiotics if infection present, oral systemic steroids, oxygen therapy, and promotion of rest to allow energy for breathing and eating.
Cor Pulmonale is a COPD complication characterized by air trapping and stiff alveolar walls increasing lung tissue pressure and narrowing blood vessels, causing the right side of heart to work harder to pump the blood to lungs, and causing the right chamber of heart to enlarge, thicken, and become inefficient.
Depression, anxiety, and panic are common in COPD patients, with rates exceeding 40%.
Discharge Teaching for COPD patients involves pacing and planning activities with rest periods, encouraging smoking cessation, promoting hand hygiene and staying away from crowds, encouraging influenza and pneumonia vaccines, and seeking medical attention promptly if symptoms of infection begin.
Pulmonary Embolus is commonly caused by a DVT that breaks off and travels to the lungs.
Recognize cues in the patient history by considering family history of respiratory illnesses such as asthma.
Anticoagulant therapy can lead to bleeding, so monitor for symptoms and take precautions.
Monitoring respiratory status involves auscultating lungs, checking oxygen saturation, checking nailbeds and skin color.
Assessing for bleeding involves checking for bruising, petechia, and monitoring for oozing around IV sites.