Modifiable Factors:

Non-Modifiable Factors:
Inhaled carcinogens • Tobacco Smoking
• Gender (Male) • Secondhand smoke
• Genetic
6h predisposition • Environmental and occupational
• Age (50 yrs. Old above) exposure (arsenic, asbestos,
mustard gas, chromates, coke
• Familial predisposition Tracheobronchial airway oven fumes, nickel and oil).
• Thirdhand smoke
• Exposure to radiation and air
pollution
Carcinogens binds to DNA of epithelial • Dietary deficits
• Underlying respiratory disease
(COPD, TB)
Surgical Management
Cellular changes Abnormal cell growth Duplication/ malignant
• Laser bronchoscopy
• Mediastinoscopy Diagnostic/Lab Test
• Thoracotomy • Chest x-ray
• Wedge resection Passing of damaged DNA to daughter cells
• CT scans of the chest
• Segmental resection • Sputum cytology
• Sleeve resection • Fiberoptic bronchoscopy
(bronchoplastic Further damage to DNA • Fine-needle aspiration
reconstruction)
• Bone scans, abdominal
• Lobectomy scans, PET scans
• Pneumonectomy • CT scan of the brain, MRI
Unstable DNA
• Mediastinoscopy or
Medication/Therapies mediastinotomy
• Endobronchial ultrasound
• Radiation therapy Malignant transformation of the pulmonary epithelium
biopsy
• Chemotherapy
• Palliative therapy
• Crizotinib (Xalkori) Invasive Carcinoma
• Ceritinib (Zykadia)
• Bronchodilators (may be prescribed ma
to reduce airway obstruction)
 Clinical Manifestations:

Respiratory System Cardiovascular System Gastrointestinal System Paraneoplastic Syndromes Metabolic

• Cough • Compression of the • Anorexia Endocrine System Process
• Hemoptysis superior vena cava • Weight
• Hypercalcemia
• Wheezing & dyspnea Loss
• Hyperphosphatemia
• Chest pain, dull or • Cushing’s syndrome • Fever
pleuritic • Syndrome of inappropriate
• Hoarseness & diuretic hormone (SIADH)
dysphagia w/ water retention &
• Pleural effusion hyponatremia
Cardiovascular System
• Thrombophlebitis
• Endocarditis
Hematologic Effects:
• Anemia
• Disseminated intravascular
coagulation (DIC)
• Eosinophilia
Connective tissue:
• Osteoarthropathy with clubbing
and periosteal inflammation
Neuromuscular Effects:
• Peripheral neuropathy
• Cerebellar degeneration
• Myasthenia-like muscle
weakness
 Nursing Diagnoses

Ineffective Ineffective Imbalance Nutrition:

Pain Activity Anticipatory
Breathing Airway Less than body Intolerance Grieving
Pattern Clearance requirements