Thoracic Surgery (Lobectomy, Pneumonectomy) for Progressive Care Certified Nurse (PCCN)
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Outline
Thoracic Surgery (Lobectomy, Pneumonectomy)
Definition/Etiology:
- Lobectomy, pneumonectomy
- Lobe vs. lung
Pathophysiology:
- Why performed?
- To diagnose a condition (e.g. cancer, TB, PF)
- Remove diseased lung
- Cancer
- Trauma
- Abscess
- Emphysema
Noticing: Assessment & Recognizing Cues:
- Preparing for surgery
- Consent for surgery
- General anesthesia
- Blood work
- Diags previously (PFT, CT scan, EKG, etc.)
Interpreting: Analyzing & Planning:
- Potential complications
- Bleeding risk
- Monitor drainage (can be sudden, assess frequently)
- Pain (expected and can be difficult to manage)
- WBCs Infection risk
- Surgical site
- Other
- Air leak
- Arrhythmia
- Bronchopleural fistula
- Hemothorax
- Pulmonary embolism
Responding: Patient Interventions & Taking Action:
- Post-procedure
- Chest-tube management (be familiar with your facility protocol)
- Suction
- Water-seal
Reflecting: Evaluating Patient Outcomes:
- Recovery after discharge
- Monitor for infection
- Pain management
- Monitor for bleeding
- Considerations
- Lobectomy vs. pneumonectomy
- Overall health
- Underlying conditions
- Open vs. minimally invasive procedure
Linchpins (Key Points):
- Surgery: ABC 1st, Prevent complications 2nd
- ABCs
- Prevent complications
- Chest tube management
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Transcript
References
- Anderson, D., Chen, S. A., Godoy, L. A., Brown, L. M., & Cooke, D. T. (2022). Comprehensive review of chest tube management: A review. JAMA Surgery, 157(3), 269-274. doi: 10.1001/jamasurg.2021.7050.
- Cleveland Clinic (2022). Lobectomy. https://my.clevelandclinic.org/health/treatments/17608-lobectomy.
- Cleveland Clinic. (2022). Lung resection. https://my.clevelandclinic.org/health/treatments/21868-lung-resection.
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