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Thoracic Surgery (Lobectomy, Pneumonectomy) for Progressive Care Certified Nurse (PCCN)

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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