What nurses need to do after pneumonectomy are as follows:
1. Make sure that patient lies on their back or the operated side but should not lie with operative side UPPERMOST because of fear that the suture of the bronchial stump may open making it possible for fluid to drain into unoperated side and then drown the patient.
2.Monitor for signs of mediastinal shift such as :Distended neck veins.
Trachea displaced to one side.
Pulse and respiration are increased.
Monitor patient check the trachea to make sure that it remains in the midline.
3.Supervise and encourage deep breathing and coughing exercises to expand the lung.
4. Monitor adequate intake and output.
Properly record amounts of intravenous fluids and blood given.
This is to prevent fluid overload. Also it is important to monitor Central venous pressure.
5.Support and encourage exercise and activity that patients can perform without leading to dyspnea.
Encourage early ambulation of patient with assistance.
6.Instruct patients to report to the doctor at once if the patient has :
Pain with swallowing or localized chest pain develops because these are signs and Symptoms of complications.
After Pneumonectomy there is no need for chest tube insertion because there is “No” lung left to re- expand on the Operated Side.Serious drainage will be collected in the operative space and over time will solidify to the consistency of axle grease. This is very important to keep the mediastinum from shifting towards the operative side.
WHAT ARE THE COMPLICATIONS OF CHEST SURGERY.
1.Hypotension which is due to blood loss.This can lead to low bood pleasure which leads to dizziness or fainting because the brain is not getting enough oxygen.
2.Cardiac dysrhythmia which is irregular beating of the heart either beating too slow or too fast.That is the electrical impulse are not working well.
3.Pulmonary edema this is a build up of fluid in the alveolar in the lungs preventing oxygen from getting into the blood.
4.Subcutaneous emphysema that is air will be trapped in the tissue beneath the skin.This is a very rare occasion. Doctors will refer to them as Crepitus,Subcutaneous air or as tissue emphysema etc.