A client with newly diagnosed small cell lung cancer reports progressive facial swelling, distended neck and c…

Question

A client with newly diagnosed small cell lung cancer reports progressive facial swelling, distended neck and chest wall veins, and dyspnea worse when leaning forward. Which nursing action is the priority?

Accepted Answer

Option 2: Elevate the head of the bed to 45 degrees and prepare for emergent airway management

SVC syndrome from mediastinal mass causes obstruction of venous return with facial/upper-extremity swelling, distended chest-wall collaterals, and dyspnea. Stridor and orthopnea signal airway compromise — elevation of the head of bed reduces venous pressure and facilitates breathing. Emergent oncology and radiation oncology consult is required; treatment is radiation therapy, chemotherapy (especially small cell), or endovascular stenting. Supine positioning WORSENS venous engorgement. Aggressive fluids increase central venous pressure and edema. Compression stockings have no role in SVC obstruction.

Answer

Option 1: Place the client supine to facilitate jugular venous return

Answer

Option 3: Begin aggressive IV fluid resuscitation to dilute tumor markers

Answer

Option 4: Apply tight compression stockings to redirect blood flow

A client with newly diagnosed small cell lung cancer reports progressive facial swelling, distended neck and chest wall veins, and dyspnea worse when leaning forward. Which nursing action is the priority?

In-depth explanation

Clinical scenario

Key concepts

Master the NCLEX-RN with MyMerci

성장을 멈추지 마세요

A client with newly diagnosed small cell lung cancer reports progressive facial swelling, distended neck and chest wall veins, and dyspnea worse when leaning forward. Which nursing action is the priority?

In-depth explanation

Clinical scenario

Key concepts

Master the NCLEX-RN with MyMerci