Nursing care of a patient undergoing lung surgery

Uvod: Kirurgija ostaja glavni diagnostični in terapevtski način za paciente z nedrobnoceličnim pljučnim rakom, uporablja pa se tudi pri nekaterih drugih boleznih pljuč, kot so pnevmotoraks, rekurentna hemoptiza in empiem plevre. Operacija je kurativen način zdravljenja ali poseg namenjen izboljšanju preživetja. Medicinska sestra ima pri oskrbi pacientov z boleznimi pljuč pomembno vlogo. Namen: Namen diplomskega dela je prikaz vloge medicinske sestre pri oskrbi pacientov z boleznimi pljuč v predoperativnem obdobju, med kirurškim posegom ter v obravnavi in zdravljenju v zgodnjem in poznem pooperativnem obdobju. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela s pregledom literature. Pri iskanju smo uporabili časovni okvir, in sicer od leta 2012 do 2020. Literatura je bila iskana v angleškem jeziku s ključnimi besednimi zvezami: lung surgery AND nurse role, lung cancer AND rehabilitation, thoracic surgery AND recovery, v podatkovnih bazah MEDLINE in CINAHL, do katerih se je dostopalo preko oddaljenega dostopa Digitalne knjižnice Univerze v Ljubljani, ter Science Direct. V analizo smo vključili 28 člankov. Upoštevali smo kvaliteto člankov glede na hierarhijo dokazov v znanstvenoraziskovalnem delu. Rezultati: Z izvajanjem programa izobraževanja pacientov, pri katerih je potrebna resekcija pljuč, izboljšamo njihovo psihološko in fizično počutje. Po-operativni pljučni zapleti so eden glavnih vzrokov umrljivosti pri pacientih z boleznimi pljuč. Pacienti se po operativnem posegu soočajo z bolečinami, depresijo in tesnobo, kar močno vpliva na pacientovo okrevanje po operaciji. Dodatno bolečino lahko povzroči torakalna drenaža, ki je prisotna pri večini pacientov v zgodnjem po-operativnem obdobju. Vloga medicinske sestre je zgodnje prepoznavanje morebitnih zapletov in primerno ukrepanje, zelo pomembno prispeva tudi k obvladovanju bolečine. Razprava in zaključek: V predoperativnem obdobju je naloga medicinske sestre predvsem prepoznavanje pacientovih specifičnih individualnih potreb in informiranje svojcev, v po-operativnem obdobju pa je usmerjena predvsem na lajšanje bolečine. Z delovanjem po priporočilih programa izboljšanega okrevanja po operaciji (enhanced recovery after surgery – ERAS) lahko medicinske sestre zagotovijo najboljšo oskrbo pacientov, operiranih na pljučih. Medicinska sestra predstavlja nepogrešljiv člen zdravstvenega tima, ki skrbi za pacienta, saj s svojim strokovnim znanjem in kompetencami ter z intervencijami zdravstvene nege ob upoštevanju standardov zdravstvene nege pomembno pripomore k celostni in kakovostni obravnavi pacienta.Introduction: Surgery remains the main diagnostic and therapeutic method for patients with non-small cell lung cancer, but it is also used in some other lung diseases such as pneumothorax, recurrent hemoptysis, and pleural empyema. Surgery is a curative treatment or procedure designed to improve survival. The nurse plays an important role in the care of patients with lung diseases. Purpose: The purpose of the diploma work is to present the role of the nurse in the care of patients with lung diseases in the preoperative period, during surgery and in the treatment in the early and late postoperative period. Methods: In the diploma work we used a descriptive method of work with a review of the literature. We used a time frame from 2012 to 2020. The literature was searched in English with key phrases: lung surgery AND nurse role, lung cancer AND rehabilitation, thoracic surgery AND recovery, in the MEDLINE and CINAHL databases, which were accessed via remote access of the Digital Library of the University of Ljubljana, and Science Direct. We included 28 articles in the analysis. We took into account the quality of articles according to the hierarchy of evidence in scientific research. Results: By implementing the education program of patients who need lung resection, we improve their psychological and physical well-being. Post-operative pulmonary complications are one of the leading causes of mortality in patients with lung disease. Patients face pain, depression and anxiety after surgery, which has a major impact on the patient\u27s recovery after surgery. Additional pain may be caused by thoracic drainage, which is present in most patients in the early postoperative period. The role of the nurse is to early identify possible complications and take appropriate action, it also makes a very important contribution to pain management. Discussion and conclusion: In the preoperative period, the nurse\u27s task is primarily to identify the patient\u27s specific individual needs, and in the post-operative period, it is primarily aimed at relieving pain. By following the recommendations of the enhanced recovery after surgery (ERAS) program, nurses can provide the best care for patients undergoing lung surgery. The nurse is an indispensable member of the medical team that cares for the patient, as her professional knowledge and competencies and nursing interventions according to the nursing standards significantly contribute to the comprehensive and quality treatment of the patient