Lung Cancer

LUNG CANCER
RUDI HAMARNO
What is lung cancer?
Lung cancer is cancer that starts in the
lungs. Cancer is a disease where
cancerous cells grow out of control,
taking over normal cells and organs
in the body.
b. Small cell lung cancer:

Types of lung cancer It is a less common type and it
a. Non-small cell lung cancer: spreads faster
It is the most common & spreads
more slowly : There are three major types :
 Squamous cell carcinoma  Small cell carcinoma
 Adenocarcinoma  Mixed small cell/large cell
 Combined small cell ca
 Large cell carcinoma
Causes of lung cancer
 usually caused by smoking or exposure to

second-hand smoke.
 Researchers : more than 90% in men and at least
70% in women are directly caused by cigarette
smoking.
 Lung cancer can also be caused by other things.

Other causes of lung cancer
 Second-hand smoke: People who regularly breathe in other

people's smoke have almost double the risk of getting lung
cancer than people who stay away from smoke. It's a fact:
Non-smokers who live or work in smoky air can get lung
cancer from second-hand smoke.
 Radon: Radon is a gas found in the soil in many parts of the
country. .
 Asbestos: asbestos is found is many workplaces and
homes.
 Other toxic products: uranium, arsenic, some petroleum
products may also increase the risk of developing lung
cancer
Who is at risk of lung cancer?
 Smoking cigarettes What is the best way to lower

 Smoking cigars & pipes your risk of lung cancer?
 Don't smoke. If you do
 Breathing in second-hand
smoke smoke, quit. The sooner
you quit smoking, the
 Asbestos
sooner your risk of lung
 Radon cancer drops.
 ..or a combination of any  It's never too late to quit.
of the above risks Also, stay away from
second-hand smoke.
What is the best way
to lower your risk of lung cancer?
 Don't smoke. If you do smoke, quit. The

sooner you quit smoking, the sooner your
risk of lung cancer drops.
 It's never too late to quit. Also, stay away

from second-hand smoke.
How smoking hurts your lungs ?
 Smoke from cigarettes, cigars and pipes is made up of
over 4,000 dangerous chemicals; many of these
chemicals are cancer-causing (carcinogens).
 Smoking damages your lungs by delivering cancer-
causing chemicals inside you, and by damaging your
lungs' natural cleaning and repair systems.
 The mucus can't trap the dirty air you breathe, and the
cilia can't push the dirty mucus out.
 This means your lungs can't clean out all the dangerous
chemicals and smoke from cigarettes.
Signs & symptoms
 A cough that doesn't go  Getting sick with

away and gets worse over pneumonia and bronchitis
time a lot
 Chest pain that doesn't go  Swollen neck and face
away  Not hungry, losing weight
 Coughing up blood without trying
 Feeling short of breath  Feeling tired
 Wheezing
 Losing your voice
(hoarseness)
How is it diagnosed?
 Medical history  Mediastinoscopy

 Chest x-ray  CT Scan
 Sputum analysis  Needle Biopsy
 Bronchoscopy
Treatment
1. Surgery
 Pneumonectomy: one entire lung is removed
 Lobectomy: a section (lobe) of the lung is
removed
 Segmentectomy/wedge resection: part of a lobe is
removed
 Laser surgery: a high-energy beam of light
destroys the cancer cells in a tumour
2. Radiation therapy
 Radiation therapy uses high-energy
radiation to kill cancer cells.
3. Chemotherapy
 Chemotherapy means taking anti-cancer
drugs, either by swallowing them or by
injection.
How can I prevent lung cancer?
 Don't' smoke. If you

smoke, quit
 Avoid second-hand
smoke
 Avoid radon
 Avoid asbestos
Pengkajian keperawatan.
Riwayat factor resiko :  Pyk paru kronik sblnya

 Perokok berat
( mayor) shg pembentukan

 Terpajan karsinogen jaringan parut dan
(polusi , asap kimia, fibrosis paru.
debu radioaktif )
Px fisik system pernapasan
 Batuk menetap ? sekresi cairan

 Mengi ? penyempitan bronkus
 Dispnea ? penyempitan jl nafas &
sekresi cairan
 Hemoptisis ? erosi kapiler jl nafas
 Sputum (bau) nekrose sel
 Nyeri dada pungung
 Effuse pleura cancer paru
 Parau tek saraf laring berulang
 Disfagia tek ca oesophagus.
 Edema muka, leher, dan lengan

menyumbat al/ vena cava superior.
 Infeksi sal nfs yang berulang

 Kaji emosional (anxietas) ?
 Kaji perub aktivitas aktif / pasif (istirahat)
 Kaji nutrisi ; BB , nafsu makan , sulit
menelan.
 Kaji gg seks spt ginekomastia,
amenorea/impotent.
Nursing Care Plans.
1. Kerusakan pertukaran gas, b/d

pengangkatan paru; gg suplai oksigen
(hipoventilasi); kap pembawa O2
Kriteria hasil :
 Ventilasi dan oksigenasi jar adekuat
 GDA normal.
 Bebas distress pernafasan
Interv:
 Catat frekuensi, kedlman nafas.
 Obs otot bantu, nfs bibir, pucat & sianosis.
 Ausk bunyi nafas
 Obs kegelisahan, perub mental & tk kes
 Pertahankan kepatenan jl nfs dg posisi,
suction & alat.
Interv
 Ubah posisi
 Dorong & Bantu lat nafas dl
 Pertahankan drainase
 Catat perub jml & tipe drainase WSD
 Obs gelembung WSD
 Kaji respon thd aktivitas
Interv:
Kolaborasi
 Oksigen
 Spirometri / tiup botol
 GDA, nadi oksimetri.
 Catat kadar Hb
2. Bersihan jl nfs tidak efektif b/d
jml/visko secret, nyeri & kelemahan
Kriteria hasil :
 Jalan nafas paten
 Cairan nafas dpt dikeluarkan
 Bunyi nafas jelas
 Bising -
Intervensi :
 Ausk bunyi nafas dan secret
 Bantu nafas dalam dan batuk
 Obs jumlah dan karakter sputum
 Suction bila batuk lemah / ronki tidak bersih
 Dorong masukan cairan peroral
 Kaji nyeri
 Lakukan latihan NFS
Kolaborasi
 Spirometri /meniup botol
 Fisio tx dada
 Oksigen
 Bronkodilator
3. Nyeri akut b/d insisi, adanya wsd,
invasi ca ke pleura/ dinding dada.
Kriteria hasil :
 Nyeri hilang/terkontrol
 Tampak rileks & istirahat dg baik
 Berpartisipasi dl aktivitas
Intervensi :
 Tanya ttg, pyb,verbal & non verbal nyeri
 Ev ketidakefektifan tx obat.
 Dorong menyatakan perasaan nyeri
 Beri lingk tenang.
 Bantu akt prwt diri, pernfs & ambulasi.
 Kolaborasi : analgesic
4. Ketakutan/ ansietas b/d krisis situasi;
ancaman perub st kesh; anc kematian.
Kriteria hasil :
 Mendiskusikan msl kecemasannya.
 Menunjukkan rentang perasaan &
penamp wajah rileks.
 Pengetahuan akurat.
Intervensi :
 Ev pemahaman p/orang dekat
 Akui rasa takut dorong ekspresikan
perasaan
 Beri kesemp bertanya & jawab dg jujur
 Catat perilaku
 Libatkan orang terdekat dl perenc prwt
Ca Paru bedah thorak
Perawat kritis
Hasil obtimal
Pre operatif
 Perlu penkes
klien & klg paham
 Hal Penting :
- Pengetahuan op
- Ruang perawatan ( RR, ICU )
- O2, obat-obatan
- Perawatan
Post Operasi
 Fokus :
a. ventilasi & reekspansi

paru
Perthnkan airway paten

Wsd yg baik
b. ROM
c. Nutrisi
d. Obs luka pdrhan &emfisema
e. O2
f. Hemodinamik
g. Posisi tidur 20 ° bila BP stabil semi fowler
h. Obs vital sign
setiap 15 mnt sampai sadar
setiap jam sampai kond stabil
setiap 2-4 jam
i. Lat batuk & nfs dalam
j. Rasa nyaman
Komplikasi bedah dada
1. 24-28 j I : hipotensi, disritmia,
edema pulmo, empisema
subc
2. Empiema & fistula

bronkopleural
Thank you

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LUNG CANCER

b. Small cell lung cancer:

 usually caused by smoking or exposure to

 Lung cancer can also be caused by other things.

 Second-hand smoke: People who regularly breathe in other

 Smoking cigarettes What is the best way to lower

 Don't smoke. If you do smoke, quit. The

 It's never too late to quit. Also, stay away

 A cough that doesn't go  Getting sick with

 Medical history  Mediastinoscopy

 Don't' smoke. If you

Riwayat factor resiko :  Pyk paru kronik sblnya

( mayor) shg pembentukan

 Batuk menetap ? sekresi cairan

 Edema muka, leher, dan lengan

 Infeksi sal nfs yang berulang

1. Kerusakan pertukaran gas, b/d

a. ventilasi & reekspansi

Perthnkan airway paten

2. Empiema & fistula

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