Nursing Case: Risk Factors, Post-Operative Complications, and Care Plan

Running head: NURSING CASE
Nursing case
Name:
Institution:
Date:

Running head: NURSING CASE
Risk factors
The patient in question is suffering from an early stage non-small cell lung cancer. He has
undergone a major surgery in order to try and deal with the disease. The thoracotomy and
lobectomy in the upper right lobe is a major and risky surgery that is usually followed by several
complications. There are several risk factors that are associated with the surgery such as
infection, collapsing of the lung, leaking of air fluid into the chest and the formation of pus
between the lungs and the walls of the chest (Irie, Nakanishi, Yasuda, Fujino, Hamada,&
Hyodo,2016).
The fact that he has underwent a surgery means that there are wounds that need to be
treated in a proper manner. The healing process has just begun and thus there need to be tender
care of the wounds and any other openings that may be there. The lack of proper care usually
leads to infection as there are several bacteria that may be lurking around .Infection is harmful as
it may lead to worsening of the part of the body that has been operated ( Nakada, Noda, Kato,
Shibasaki, Mori, Asano, & Ohtsuka,2019). Also, the surgery is conducted on the lungs which
are a sensitive part of the body due to the functions that it carries out. The surgeons need to be

Running head: NURSING CASE
careful when conducting the surgery in order to protect the lungs from any harmful substance. In
some cases, the surgery may be so intense leading to the body not being able to sustain it and this
leads to the collapse of the lungs. Another risk factor is that of air fluid leaking into the chest.
This is a very dangerous thing as no fluid is required to go into the chest. Any such happenings
may result in the lungs not functioning properly and this will result to lack of breath and finally
death. Therefore it is important that the surgeon is careful in the surgery process (Ueda,
Murakami, Tanaka, & Hamano, 2019)
Post-operative complications
There are several complications that may arise after the conclusion of the thoracotomy
and lobectomy surgery. The patient therefore needs to be observed carefully in order to minimize
the effects of these complications. One such complication is that of hemorrhage (Agostini,
Lugg, , Adams, Smith, Kalkat, Rajesh, & Bishay,2018).This is the immediate bleeding after the
surgery and can be as a result of surgical bleeding or coagulopathy. The patient mat bleed
profusely and if not checked will result in death in a matter of hours. It is recommended that any
chest output of 1000ml in an hour should result in the patient being taken back to the operating
room .In order to correct the bleeding, a set of coagulation tests are performed and the bleeding
stopped. In some cases, the prescription given may lead to the patient to start bleeding and thus it
is important that the nurses check on this and act immediately to save the patient (Chen, Yamada,
Sato, Aoyama, Takahagi, Menju, & Date, 2015).
Another form of complication that may occur after the surgery is cardiac complication (
Ibrahim, & Burt, 2019). This is the most common type of complications that affect a huge
number of patients that have undergone the surgery. The lung is a sensitive part and thus the

Running head: NURSING CASE
chances of the patient developing cardiac problems are high. The functioning rate of the lungs is
affected and the patient may find himself breathing at a much faster rate (Tuinman, et al,2017).
The nurses need to monitor the patient in order to check on any sign of cardiac complications. In
such cases, the patient may be given a blocking agent that is usually recommended for the
controlling of the rate (Karadag, Calıskan, & Iseri, 2016)..
Also, the patient may suffer from right to left shunt. This usually occurs due to the
pressure that is being exerted on the right hand side of the lungs during the cause of the surgery.
Intense pressure may result in a reflex that results in the right to left shunt (Bendixen, Jørgensen,
Kronborg, Andersen, & Licht,2016).
Ischemia is another complication that may come about as a result of the surgery. It
normally occurs when there is no enough blood supply to the specific organ of a body. The
lobectomy surgery takes a toll on the patient and this may lead to blockage of several arteries
that may transmit blood to the lungs. The blockage result in the shortage of blood and this will
put the patient in danger. The nurses ought to ensure that all the arteries and veins are clear so as
to avoid such complications (Vannucci, & Gonzalez-Rivas,2016).
Care plan
Mobilization
The patient may be unable to freely move
Nurse assessment and intervention
Check on the patient functional level
The nurse to assess how the patient is functioning