Lung Cancer Nursing Care Plan & Management


  • Also called bronchogenic cancer.
  • It is a malignant tumor of the lung arising within the bronchial wall or epithelium.
  • Bronchogenic cancer is classified according to cell type: epidermoid (squamous cell – most common), adenocarcinoma, small cell (oat cell) carcinoma, and large cell (undifferentiated) carcinoma.
  • The lung is also a common site of metastasis from cancer elsewhere in the body through venous circulation or lymphatic spread.
  • The primary predisposing factor in lung cancer is cigarette smoking.
  • Lung cancer risk is also high in people occupationally exposed to asbestos, arsenic, chromium, nickel, iron, radioactive substances, isopropyl oil, coal tar products, and petroleum oil mists.
  • Complications include superior vena cava syndrome, hypercalcemia (from bone metastasis), syndrome of inappropriate antidiuretic hormone (SIADH), pleural effusion, pneumonia, brain metastasis, and spinal cord compression.
Risk Factors

  • Approximately 80% of lung cancers are related to cigarette smoking. Lung cancer is 10 times more common in smokers than in nonsmokers. In particular,squamous cell and small cell carcinoma are associated with smoking
  • Other risk factors include exposure to carcinogenic industrial and air pollutants—such as asbestos,coal dust,radon,and arsenic
  • Family history
  • New or changing cough, dyspnea, wheezing, excessive sputum production, hemoptysis, chest pain (aching, poorly localized), malaise, fever, weight loss, fatigue, or anorexia.
  • Decreased breath sounds, wheezing, and possible pleural friction rub (with pleural effusion) on examination.
Diagnostic Evaluation
  • Chest X-ray may be suspicious for mass; CT or position emission tomography scan will be better visualize tumor.
  • Sputum and pleural fluid samples for cytologic examination may show malignant cells.
  • Fiberoptic bronchoscopy determines the location and extent of the tumor and may be used to obtain a biopsy specimen.
  • Lymph node biopsy and mediastinoscopy may be ordered to establish lymphatic spread and help plan treatment.
  • Pulmonary function test, which may be combined with a split-function perfusion scan, determines if the patient will have adequate pulmonary reserve to withstand surgical procedure.
Primary Nursing Diagnosis
  • Ineffective airway clearance related to obstruction caused by secretions or tumor
Medical Management
  • Oxygen through nasal cannula based on level of dyspnea.
  • Enteral or total parenteral nutrition for malnourished patient who is unable or unwilling to eat.
  • Removal of the pleural fluid (by thoracentesis or tube thoracostomy) and instillation of sclerosing agent to obliterate pleural space and fluid recurrence.
  • Radiation therapy in combination with other methods.
Surgical Intervention
  • Resection of tumor, lobe, or lung.
Pharmacologic Intervention
  • Expectorants and antimicrobial agents to relieve dyspnea and infection.
  • Analgesics given regularly to maintain pain at tolerable level. Titrate dosages to achieve pain control.
  • Chemotherapy using cisplatin in combination with a variety of other agents and immunotherapy treatments may be indicated.