Question

A removal of the left lower lobe of the lung is performed on a client with lung cancer. Which post-operative measure would usually be included in the plan? A. Closed chest drainage B. A tracheostomy C. A mediastenal tube D. Percussion vibration and drainage

Short answer

A. Closed chest drainage

Step-by-step solution

Evaluating Option A: Closed chest drainage

Closed chest drainage is used to remove air, blood, or fluid from the pleural cavity and re-expand the lung. This is a common post-operative measure for lung surgery, including the removal of a lung lobe. So, this could be a possible correct answer.

Evaluating Option B: A tracheostomy

A tracheostomy creates an opening in the neck to connect a breathing tube directly to the trachea. This procedure is usually performed for patients with airway obstructions or severe respiratory problems. It is not commonly done following a lobectomy for lung cancer, so this is not a likely correct answer.

Evaluating Option C: A mediastenal tube

A mediastinal tube is used to drain fluid and blood from the mediastinum, which is the space between the lungs. This post-operative measure is commonly employed after heart surgery but not as a standard intervention after a lobectomy for lung cancer. Hence, this is not the correct answer.

Evaluating Option D: Percussion Vibration and Drainage

Percussion Vibration and Drainage (PVD) is a chest physiotherapy technique that helps mobilize secretions in the lung and improve pulmonary function. Although this technique could be beneficial for lung cancer patients in general, it is not a specific post-operative measure for someone who just had a lobectomy. Therefore, it is not the correct answer.

Conclusion

After analyzing each option, it's clear that the most appropriate post-operative measure for a client who had a left lower lobe lung removal due to lung cancer is Option A, Closed chest drainage.

Key concepts

Post-Operative Care in Lung Cancer

After a lung surgery, like a lobectomy, proper post-operative care is essential to ensure a smooth recovery and prevent complications. One key aspect is close monitoring and managing any lingering effects of anesthesia. It's crucial to keep an eye on the patient's respiratory system and signs of distress. This includes monitoring oxygen levels and respiratory rates.

• Implementing adequate pain management strategies is key, as pain can impair breathing and lead to further complications.
• The use of closed chest drainage systems is common to facilitate lung re-expansion by removing air, blood, or fluids from the chest cavity.
• Regularly checking the chest tube for blockages or air leaks is crucial to ensure its efficiency.
• Patients are encouraged to perform breathing exercises and, if necessary, use incentive spirometry to aid lung function recovery.

Understanding these measures helps in keeping the patient's recovery on track. Each component plays a significant role in ensuring patients regain their strength and lung functionality at the soonest time possible.

Nursing Procedures for Lobectomy

Performing a lobectomy involves removing one of the lung lobes, and thorough nursing procedures come into play before, during, and after surgery. Pre-operatively, nurses educate the patient about what to expect from the surgery and help in alleviating anxiety.

• Ensuring that informed consent is obtained is a priority.
• Nurses also assist in preparing the patient's skin and maintaining fasting protocols before the surgery.

During the surgery, nurses are responsible for maintaining a sterile environment and assisting the surgical team as needed.
After the surgery, monitoring and assessment are critical. Nurses must continually check the patient's vital signs to ensure stability and monitor for any signs of distress. It's vital to assess the surgical site and chest tube for indications of complications such as infection or blockage.

• Ongoing patient education about post-operative care can foster independence in managing recovery at home.
• Help in mobilizing patients as early as possible to prevent complications such as pneumonia or deep vein thrombosis.

Being adept at these procedures enables nurses to support patients all throughout their surgical journey, ensuring a successful surgery and recovery.

Nursing Examinations

Aspiring nurses must be well-prepared for their examinations, understanding not just theoretical knowledge but practical applications as well. Nursing examinations often cover an extensive range of topics, necessitating proficiency in both foundational nursing concepts and advanced medical procedures.

• Examinations like the NCLEX-PN test on critical areas such as patient care, safety measures, pharmacological therapies, and health promotion.
• Students need to grasp concepts like post-operative care in lung cancer and lobectomy procedures, as these are commonly included in exams.
• Interactive study methods, including simulated scenarios of clinical practices, can offer deep insight and solidify understanding.
• Practice exams are essential, allowing students to familiarize themselves with the format and timing of the questions.

Being well-rounded in their studies will help nursing students not only pass their exams but also lay a strong foundation for their future careers. Comprehensive knowledge and practiced skills ensure they can provide the highest level of care to their patients.