You are on page 1of 14

INTRODUCTION

Lung cancers, also known as bronchogenic carcinomas ("carcinoma" is another
term for cancer). It is the most common cause of death due to cancer in both
men and women throughout the world.
Lung cancer is predominantly a disease of the elderly; almost 70% of people
diagnosed with lung cancer are over 65 years of age, while less than 3% of lung
cancers occur in people under 45 years of age.
In Stage 4, the cancer has spread to both lungs, to fluid in the area around the
lungs, or to another part of the body, such as the liver or other organs
(metastasis).
In the U.S., lung cancer has surpassed breast cancer as the most common
cause of cancer-related deaths in women.
Statistics from the American Cancer Society estimated that in 2014 about
224,000 new cases of lung cancer in the U.S. occurred and about 159,000
deaths were due to the disease.
According to the Philippine Society of Medical Oncology (PSMO), lung cancer
leads among the top five cancers leading to death in the country.
Despite the strict implementation of Anti-smoking ordinance in Davao City, Davao
City Health Office (CHO) recorded a total of 45 cases of lung cancer for the first
five months in 2014. On January to October of the same year, the statistics of
CHO showed that there were over 23 mortality cases. Posing an increase of one,
there were only 44 cases of lung cancer on the previous year.
We choose this case for our study, because it has a complex problem. As more
and more Filipinos are now dying of lung cancer. And this study will gave us the
facts on the disease process this case and also provided us new knowledge and
ideas to understand the condition that most men have suffer.
1 | Page

OBJECTIVES
The basic concern of this case study is to present information about the
case. That would provide the students, readers, and the future researcher in
2 | Page

gaining information about Bronchogenic Carcinoma and its complication. This will
serve as a guide on their plan of care on their future encounters with patient
having the same disease process.
SPECIFIC OBJECTIVES

To establish a trusting relationship with the client, family and significant

others.
To gather the patients personal data, family background, social economic

background and medical health history.
To discuss the anatomy and physiology specifically of the Respiratory

System related to the disease process.
To be able to discuss about the etiology and symptomatology of the


disease.
To trace the pathophysiology of Bronchogenic Carcinoma.
To identify the clients primary problem and formulate effective nursing care

plan.
Provide and disseminate important information as teachings to the client
and the significant others to boost the knowing and understanding of the

nature of the said health condition.
To discuss the medication taken by the client.

Anatomy and Physiology
RESPIRATORY SYSTEM

The Act of Breathing
Breathing starts at the nose and mouth. You inhale air into your nose ormouth,
and it travels down the back of your throat and into your windpipe, or trachea.
Your trachea then divides into air passages called bronchial tubes.
3 | Page

For your lungs to perform their best, these airways need to be open during
inhalation and exhalation and free from inflammation or swelling and excess or
abnormal amounts of mucus.
As the bronchial tubes pass through the lungs, they divide into smaller air
passages called bronchioles. The bronchioles end in tiny balloon-like air sacs
called alveoli. Your body has over 300 million alveoli.
The alveoli are surrounded by a mesh of tiny blood vessels called capillaries.
Here, oxygen from the inhaled air passes through the alveoli walls and into
the blood.
After absorbing oxygen, the blood leaves the lungs and is carried to your heart.
Your heart then pumps it through your body to provide oxygen to the cells of your
tissues and organs.
As the cells use the oxygen, carbon dioxide is produced and absorbed into the
blood. Your blood then carries the carbon dioxide back to your lungs, where it is
removed from the body when you exhale.

The Diaphragm's Role in Breathing
Inhalation and exhalation are the processes by which the body brings in oxygen
and expels carbon dioxide. The breathing process is aided by a large domeshaped muscle under the lungs called the diaphragm.
When you breathe in, the diaphragm contracts downward, creating a vacuum
that causes a rush of fresh air into the lungs.
The opposite occurs with exhalation, where the diaphragm relaxes upwards,
pushing on the lungs, allowing them to deflate.

Clearing the Air
The respiratory system has built-in methods to prevent harmful substances in the
air from entering the lungs.

4 | Page

Hairs in your nose help filter out large particles. Microscopic hairs, called cilia,
are found along your air passages and move in a sweeping motion to keep the
air passages clean. But if harmful substances, such as cigarette smoke, are
inhaled, the cilia stop functioning properly, causing health problems
like bronchitis.
Mucus produced by cells in the trachea and bronchial tubes keeps air passages
moist and aids in stopping dust, bacteria and viruses, allergy-causing
substances, and other substances from entering the lungs.
Impurities that do reach the deeper parts of the lungs can often be moved up via
mucous and coughed out or swallowed.

SYMPTOMATOLOGY

ACTUAL

IMPLICATION

SYMPTOMS

5 | Page

Chest pain

 Advanced lung cancer that spreads to the lining of
a lung or to another area of the body can cause
pain.
When lung cancer causes chest pain, the
discomfort may result from enlarged lymph nodes
or metastasis to the chest wall, pleura (lining
around the lungs), or the ribs.
http://www.healthline.com/
 Lung cancer can cause bleeding in the airway,

Hemoptysis/ Coughing
up blood

which can cause you to cough up blood
(hemoptysis). Sometimes bleeding can become
severe.

Shortness of breath

http://www.mayoclinic.org/
Shortness of breath occur when cancer grows to
block the major airways. Lung cancer can also
cause fluid to accumulate around the lungs,
making it harder for the affected lung to expand
fully when you inhale.

Chronic cough

http://www.mayoclinic.org/
The cough reflex is triggered by mechanical or
inflammatory changes or irritants in the airways.
Chronic cough is often associated with bronchial
hyperreactivity. At least half of people diagnosed
with lung cancer have a chronic cough at the time
of diagnosis. Defined as a cough that lasts for at
least 8 consecutive weeks.
http://lungcancer.about.com/

Fluid in the chest
(pleural effusion)

Lung cancer can cause fluid to accumulate in the
space that surrounds the affected lung in the chest
cavity (pleural space).
6 | Page

http://www.mayoclinic.org/

Wheezing

When airways become constricted, blocked, or
inflamed, the lungs produce a wheezing or
whistling sound when you breathe.
http://www.healthline.com/
An unexplained weight loss of 10 pounds or more

Weight loss

may be associated with lung cancer or another
type of cancer. When cancer is present, this weight
drop may result from cancer cells using energy in
the body. It could also result from shifts in the way
the body uses food energy
http://www.healthline.com/
Changes in the voice

Hoarseness related to lung cancer can occur when

or being hoarse

the tumor affects the nerve that controls the larynx,
or voice box.
http://www.healthline.com/

ETIOLOGY

ACTUAL

Smoking

CAUSE

IMPLICATION
The incidence of lung cancer is strongly correlated with
cigarette smoking, with about 90% of lung cancers arising
as a result of tobacco use. The risk of lung cancer
increases with the number of cigarettes smoked and the
time over which smoking has occurred; doctors refer to this
risk in terms of pack-years of smoking history (the number
of packs of cigarettes smoked per day multiplied by the
number of years smoked).
7 | Page

While the risk of lung cancer is increased with even a 10pack-year smoking history, those with 30-pack-year
histories or more are considered to have the greatest risk
for the development of lung cancer.
Tobacco smoke contains over 4,000 chemical compounds,
many of which have been shown to be cancer-causing or
carcinogenic. The two primary carcinogens in tobacco
smoke are chemicals known as nitrosamines and polycyclic
aromatic hydrocarbons.
http://www.medicinenet.com/
Cigarette and cigar smoke contains more than 40
carcinogens or cancer-causing chemicals. Among these
are tar, nicotine, cyanide, formaldehyde, methanol,
ammonia, acetone, carbon monoxide, and nitrogen oxide.
Tar is a dark, sticky substance condensed from the
chemical particles in cigarette smoke. A one-pack-a-day
smoker collects about one cup of tar in his lungs in a year,
according to the PCSI publication, Lung Cancer and
Smoking. The tar from cigarette smoke affects the defenses
of the lungs, neutralizing them so that they can’t do their
Age
( 64 yrs. old)
Sex (Male)


work.
It is most common between the ages of 45 and 70.
http://www.rxmed.com/
It is approximately three times more common in men than
females.

Heredity

http://www.meddean.luc.edu/
People with a parent, sibling or child with lung cancer have
an increased risk of the disease.

Exposure to

http://www.mayoclinic.org/
Workplace exposure to asbestos and other substances

asbestos and

known to cause cancer — such as arsenic, chromium and

other

nickel — also can increase your risk of developing lung
8 | Page

carcinogens.

cancer, especially if you're a smoker.

Air pollution

Air pollution from vehicles, industry, and power plants can
raise the likelihood of developing lung cancer in exposed
individuals. Up to 1% of lung cancer deaths are attributable
to breathing polluted air, and experts believe that prolonged
exposure to highly polluted air can carry a risk for the
development of lung cancer similar to that of passive
smoking.

Lung

http://www.medicinenet.com/
The presence of certain diseases of the lung,

diseases

notably chronic obstructive pulmonary disease (COPD), is
associated with an increased risk (four- to six-fold the risk
of a nonsmoker) for the development of lung cancer even
after the effects of concomitant cigarette smoking are
excluded. Pulmonary fibrosis (scarring of the lung) appears
to increase the risk about seven-fold, and this risk does not
appear to be related to smoking.
http://www.medicinenet.com/

9 | Page

I

SYNTHESES OF CLIENT’S CONDITION

A Conclusion
In general, the overall prognosis is fair. He had a final diagnosis of
Coronary Artery Disease. He has the willingness to take in the medication. The
medical team also gave the due care she needed. The family as well as the
significant others supported her physically, emotionally and financially. They
provided the client with the medications needed and other diagnostic
examinations. She has also strong faith in God. Furthermore, the client shows
willingness to recover by following the doctors’ orders and advices.
B Prognosis
CRITERIA
Duration of Illness

POOR

FAIR

GOOD

1

2

3

JUSTIFICATION
I rated it as fair since his condition

doesn’t worsened.
Onset of Illness

I rated it as good since he have
consulted to the physician immediately
about his condition.
10 | P a g e

Age

The patient age belongs to adult which

the recovery process is fair.
Willingness to take

The

patient

comply

interest
the

and

medication

willingness

Lifestyle

treatment for his recovery.
I rated fair because he is fond of eating

to

shows

needed

salty and fatty foods but has willingness
Family Support

to change his lifestyle.
Good, because our client’s family is
indeed very supportive, giving the best
support both morally and emotionally.

COMPUTATION:
POOR

:

1X 0 = 0

FAIR

:

2X 3 = 6

GOOD

:

3X3=9

0+ 6+ 9 = 15/ 6 = 2.5

;

Fair Prognosis

A. Recommendation
The following are the group’s recommendation for a faster therapeutic effect:

To the patient

 Instruct the patient to follow medical regimen by continuing the medications
as ordered by the physician.
 Instructed to limit eating salty and fatty foods.
 Adequate rest and sleep for faster recovery.
11 | P a g e

 Provide health teaching to the patient.

To the family
 Recommend the patient’s immediate family members to provide adequate
support, care and understanding to the patient’s situation.
 Encouraged to maintain eating healthy and nutritious foods.

 Develop knowledge about the patient’s recovery status to avoid further
complications.

12 | P a g e

BIBLIOGRAPHY
Books
Brunner and Suddart. Medical Surgical Nursing. 10 th Edition. Published by
Lippincott Williams and Wilkins. © 2008
Doenges et. Al. Nurses Pocket Guide. Published by F.A Davis Company
Philadelphia. © 2010
Koizer, Barbara. Erb, Glenora. Berman, Audrey. Snyder. Copyright
2008.Fundamentals of Nursing Vol. 1. Eight Edition. Pearson Education Inc.
Koizer, Barbara. Erb, Glenora. Berman, Audrey. Snyder. Copyright
2008.Fundamentals of Nursing Vol. 2. Eight Edition. Pearson Education Inc.
Spratto et a. Delmar’s Nurses Drug Handbook. Published by Delmar. © 2010
Tortora and Derrickson. Essential of Anatomy and Physiology. Pulished by John
Wiley

and

Sons

(Asia)

Pte

Ltd.

©

2010

Electronic Media
http://www.rxmed.com/b.main/b1.illness/b1.1.illnesses/Lung%20Cancer
%20(Bronchogenic%20Carcinoma).html
http://www.webmd.com/lung-cancer/guide/lung-cancer-types?page=2
http://www.meddean.luc.edu/LUMEN/meded/elective/pulmonary/lungca/lungca._f
.htm
http://www.healthline.com/health/lung-cancer-symptoms#Overview1
http://lungcancer.about.com/od/Cough/f/Lung-Cancer-Cough.htm
http://patient.info/doctor/chronic-persistent-cough-in-adults
http://www.medicinenet.com/lung_cancer/page3.htm
http://www.cancercenter.com/lung-cancer/stages/tab/non-small-cell-lung-cancerstage-4/
http://www.webmd.com/lung-cancer/
13 | P a g e

http://www.mayoclinic.org/diseases-conditions/lung-cancer/basics/riskfactors/con-20025531

14 | P a g e