Question

Read the following scenario:

The intensive care unit (ICU) nurse calls to give you the following report: "D.S. is a 66-year-old man with a past medical history of chronic bronchitis. He quit smoking 12 years ago and exercises regularly. He went to see his physician with complaints of increasing exertional dyspnea; a large mass was found in his right lung. Three days ago, he underwent a right middle and lower lobe lobectomy; the pathology report showed adenocarcinoma. He has no neurologic deficits. His vital signs run 120/70, 110, about 30, with a fever around 100.2° F. His heart tones are clear, all peripheral pulses are palpable, and he is receiving IV D5 1/2 NS at 50 mL/hr in his right forearm. He has a right midaxillary chest tube to Pleur-evac drain; there is no air leak, and it is draining small amounts of serosanguineous fluid. He has complaints of pain at the insertion site, but the site looks good, and the dressing is dry and intact. He is on 5 L oxygen by nasal cannula. He refuses pain medication. He is a real nervous person and has not slept since surgery. He'll be there in about 20 minutes."

Think through the following related to D.S.'s condition:

Etiology and pathophysiology

Risk factors

Signs and symptoms

Diagnostic procedures

Medication and treatment

Nursing interventions, including patient education

Potential complications

Complete a concept map

Answer 1