Nursing Assignment on Lung Cancer and Chemotherapy Medication

Running head: NURSING ASSIGNMENT
Nursing Assignment
Name of the student:
Name of the university:
Author note:

1Nursing Assignment
Introduction:
Lung cancer is one of the leading cause of death related to cancer. According to Abs.gov, (2019),
Australia the death rate caused by lung cancer is around 5.3% of all death. The rate of lung cancer is
high in case of men as compared to women. The prognosis of lung is very poor which means the
incidence rate of lung cancer is almost same as that of the mortality rate (Corre et al. 2016). This essay
focuses on the a patient who is suffering from lung cancer and also has been diagnosed with metastases.
People suffering from lung cancer usually feel shortness of breathing, chest pain, diarrhea, nausea and
vomiting (Walte et al.2015). In the assignment the pathophysiology of the lung cancer which is
responsible for the shortness of breathing is explained in detail. Metastases of the lung cancer and their
effect on liver is also mentioned. The patient is relying on chemotherapeutic agents, hence the
pharmacokinetics of the chemotherapeutic drugs has been stated. Effectiveness and adverse effect of the
chemotherapeutic agents has also been addressed. Cisplatin is used in the combination with docixatol for
the effective treatment of the lung cancer. Nuvilumab is also used in the treatment of the cancer. In the
assignment both the medication are compared. The patient is administered with morphine IV which also
has side effect such as, nausea, constipation, vomiting and to reduce that Naloxone is prescribed.
Pathophysiology of the lung cancer:
Lung cancer is of two types among which the rate of non-small lung cancer is high as compared
to small cell lung cancer. One of the most important risk factor that results in lung cancer is smoking. It
is also caused due to genetic factors or the environmental factors such as asbestos, tar, soot and metals
such as chromium, arsenic and nickel. Certain dietary which contain beta carotene is also responsible for
the lung cancer. These risk factor damages the cell lining of the lung causing lung cancer. In the case
study, Nigel is suffering from non-small lung cancer (DiPiro et al 2014). He is at stage 4 of the lung
cancer and metastasis has also been observed. Due to the lung cancer the patient is suffering from

2Nursing Assignment
shortness of breathing. When the epithelial cells of the lungs damages and starts to grow exponentially,
it can cause lung cancer. The epithelial cancer can cause difficulties in the breathing and also shortness
of breathing. In case of lung cancer, the airway gets blocked due to which the mucus that is trapped in
the lung can cause infection which creates lack of oxygen. Lack of oxygen can cause shortness of
breathing. Hence in case of lung cancer, the patient usually suffer from breathing difficulty (Sadik et al.
2014).
Lung cancer effects the epithelial cells of the body. It starts from lung and spread to lymph node,
kidney, brain and other parts of the body. In metastasis, the cells break from their origin of site to other
distant sites. The cancerous cells reaches to the other distant sites through blood stream or the lymphatic
system. As the lungs and liver are situated adjacent to each other, the cancerous cells of lungs can easily
effect the liver. It also effects the metabolism of liver by affecting the lymph nodes which leads to liver
damage. In case of Nigel, due to the metastasis, his health is getting deteriorated (Reck et al. 2014).
Chemotherapy medication’s pharmacokinetics:
According to the case study, the patient is suffering from stage 4 non-small lung cancer, which
has been spread to different sites other than the site of origin. The metastasis of the lung cancer is
distributed all over the body. As the lung plays an important role in the drug metabolism, the
pharmacokinetics of the drugs is also effected. The first pass metabolism is defined as the process
where the drug absorption is reduced before reaching to systematic movement through the blood. Nigel
was administered with chemotherapeutic drugs by oral administration. Both the drug which has been
administered to the patient is absorbed by the liver and helps in further metabolism of drugs which is
excreted in the form of urine. These drugs after administration pass to the digestive system through the
hepatic system by portal vein. This metabolized drugs are then converts into small active drug that
emerges in the rest of the circulatory system. Hence by such process the hepatic first-metabolism is

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reduced to minimal (Rapoport et al. 2015). As the patient is suffering from second cancer the drug is
infused intravenously in to the patient, where the chemotherapeutic drug is administered directly in to
the veins and is absorbed more efficiently. It directly acts on the site of infection and is more effective in
the treatment of cancer. Whereas, in the case of oral administration, the half of the amount of the drug is
lost due to digestion and then metabolism into the liver. Therefore it is more convenient to administer
these drugs intravenously not orally. The bioavailability of such chemotherapeutic drugs which is IV
infusion is about 100%, hence the drug can very easily dodge first pass metabolism. Hence, by
considering the second cancer liver, it can be stated that it has no effect on the pharmokinetics of the
drugs which include, cisplatin and docexatol, as it can directly act on the drug through the blood stream
(Kenmotsu and Tanigawara 2015)
Effect of chemotherapeutic drug on lung cancer:
According to the case study, Nigel who is 78 years old has been diagnosed with stage four cancer
named as non-small lung cancer which was further formed to metastasis. In order to treat the lung
cancer, the patient is administered with Cisplatin and docetaxel. Cisplatin and docetaxel is given
intravenously in about every three weeks. The combination of cisplatin and docexatol is very commonly
used in the treatment of lung cancer. Cisplatin is chemotherapeutic drug which contain platinum which
is very effective in the treatment of cancer. It works to stop the metastasis of the patient by cross linking
with the guanine bases of the double stranded DNA helix. As a result of the drug the DNA strand is
unable to uncoil. These uncoiling of DNA stops the cell division. Due to which the cancer cells are
unable to divide further and hence their growth stops (Qin et al. 2017). It also effects the downstream
process of the DNA by adding methyl group to it. Addition of methyl group induces miscoding of the
bases of the DNA strand. Addition of methyl group creates hindrance in the RNA transcription and as
well as protein synthesis (Li et al. 2015). However, if is the advanced stage of lung cancer, the drug