Thoracic Surgery (Lobectomy, Pneumonectomy)

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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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Progressive Care Certified Nurse (PCCN)

Beth Hendricks

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Emily Nelson

RN, DNP, NPD-BC, PCCN-K, CNE

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