Post-operative Specific Care

　

Update Series on Respiratory Nursing

Carcinoma of Lung

　

　

Perioperative Care (Pre-op, Intra-op, Post-op)

　

　

Ca Lung

Management

TMN Definitions

Operation

Pre-operative care

Intra-operative care

Post-operative care

　

Post-operative Care (Specific care)

　

　

Drainage

　

	Negative pressure, usually ~ 5 kPa
	- Expansion of the remaining lung - Obliteration of the pleural space - Tamponading any air or blood leak
	Two drains
	- AAA: Apical Air Anterior - BBP: Basal Blood Posterior
	Airleak
	- Common to have airleak after operation especially in old age, emphysematous lung - Check suction if no airleak and swinging
	Output
	- Q1h for the first day then daily

　

Usually off drains around D3 if no airleak
Tips of drains send for culture if sepsis is
suspected or in case of pneumonectomy

　

　

Pneumonectomy case

　

　

　

Sputum retention

　

　

	Expectoration
	- Bisolvon - Fluimucil
	Analgesic
	Antibiotics
	- Sputum for culture

　

　

	Ambulation
	Chest physiotherapy
	- Vibration - Percussion - Postural drainage - Breathing exercise (incentive spirometry)
	Steam inhalation
	Fibreoptic bronchoscopy
	Tracheostomy
	Ventilator support

　

　

　

Ward

　

　

	May transfer to ICU if high risk cases or complicated cases, otherwise, usually stay in HD for at least postop day
	- Resume diet next day - Off IVF if feeding well - CXR D1-D3, after off suction and off drain - See wound around D3-5 - Discharge on D7 - Off stitches on D10 if any

	- Disclosure

　

　

　

Discharge

　

　

	- See again 4 weeks after discharge, then every 3-4 months for 2 years and then every 6-12 months
	- CXR

　

　