Page 1289 - Saunders Comprehensive Review For NCLEX-RN

5. Place in a Fowler’s position to help ease

breathing.
6. Administer oxygen as prescribed and

humidification to moisten and loosen secretions.
7. Monitor pulse oximetry.
8. Provide respiratory treatments as prescribed.
9. Administer bronchodilators and corticosteroids as
prescribed to decrease bronchospasm, inflammation,
and edema.
10. Provide a high-calorie, high-protein, high-vitamin diet.
11. Provide activity as tolerated, rest periods, and active
and passive range-of-motion exercises.
E. Nonsurgical interventions
1. Radiation therapy may be prescribed for localized
intrathoracic lung cancer and for palliation of
hemoptysis, obstructions, dysphagia, superior vena
cava syndrome, and pain.
2. Chemotherapy may be prescribed for treatment of
nonresectable tumors or as adjuvant therapy.
F. Surgical interventions
1. Laser therapy: To relieve endobronchial obstruction
2. Thoracentesis and pleurodesis: To remove pleural
fluid and relieve hypoxia
3. Thoracotomy (opening into the thoracic cavity) with
pneumonectomy: Surgical removal of 1 entire lung
4. Thoracotomy with lobectomy: Surgical removal of 1
lobe of the lung for tumors confined to a single lobe
5. Thoracotomy with segmental resection: Surgical
removal of a lobe segment
G. Preoperative interventions
1. Explain the potential postoperative need for chest
tubes.

2. Note that closed chest drainage usually is not

used for a pneumonectomy, and the serous fluid that
accumulates in the empty thoracic cavity eventually
consolidates, preventing shifts of the mediastinum,
heart, and remaining lung.
H. Postoperative interventions
1. Monitor vital signs.

2. Assess cardiac and respiratory status; monitor

lung sounds.

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