Lung Cancer Evolve Case Study

Lung Cancer
Jean Flick, RN, MS; Marty Carlson, RN, MS; and Diane Maxwell, RN, MS
Top of Form

Diagnostic Tests

The healthcare provider completes the examination and prescribes a chest x-ray, which is scheduled for the next morning.
1.
Which instructions should the nurse provide to prepare Mr. Prieto for the x-ray?
A) "You should not eat or drink anything after midnight."
Feedback: INCORRECT
It is not necessary to be NPO prior to an x-ray.

B) "You will need to remove jewelry, such as neck chains."
Feedback: CORRECT
Jewelry interferes with obtaining a clear and accurate x-ray.

C) "Notify the technician if you are allergic to shellfish."
Feedback: INCORRECT
This is only necessary if a diagnostic test involves the application of a topical iodine-based agent or the injection of an iodine-based dye.

D) "You will be given a mild sedative to reduce any anxiety."
Feedback: INCORRECT
Sedatives are not generally administered before x-rays.

Correct answer(s): B
The chest x-ray results show a suspicious spot on Mr. Prieto's left lung, and he is scheduled for a lung biopsy via fiberoptic bronchoscopy.
2.
What nursing action should the nurse expect to implement following this procedure?
A) Reinforce the pressure dressing over the biopsy site.
Feedback: INCORRECT
The biopsy site is internal, which may be passed through the nose, mouth, or a stoma.

B) Assess for return of the client's gag reflex.
Feedback: CORRECT
Mr. Prieto should remain NPO until the gag reflex has returned. Prior to the procedure, he will be given a topical anesthetic, both to gargle and through an aerosol mask to numb the back of the throat.

C) Encourage Mr. Prieto to force fluids.
Feedback: INCORRECT
There is no need to increase fluid intake.

D) Maintain a chest tube drainage device as prescribed.
Feedback: INCORRECT
Chest tubes are not inserted during bronchoscopy.

Correct answer(s): B
Risk Factors

Biopsy results confirm that Mr.