How to Care for a Post-Pneumonectomy Patient: An Interview With Nurse Practitioner April Thomas

In this highly educational interview, Cristina Ruiz Segria, CTSNet Senior Editor—Clinical Care Providers and nurse practitioner at James Cook University Hospital, UK, interviews April Thomas, an inpatient acute care nurse practitioner specializing in thoracic surgery at The University of Texas MD Anderson Cancer Center, Texas, USA. They discuss an extraordinary presentation prepared by April Thomas on the care of post-pneumonectomy patients.  

The conversation begins with an exploration of the reasons behind the creation of this presentation and the advantages it offers to nurse practitioners. They then delve into the specifics of the presentation content, which provides an anatomy refresher on the lungs, segments, and bronchi. The discussion then transitions to various critical topics in blood drain management, including troubleshooting techniques, when to notify an Advanced Practice Provider (APP) or attending physician, irrigation and obtaining samples, and monitoring during irrigation.  

Next, they cover the topic of pneumonectomy, highlighting the crucial point of never clamping a pneumonectomy drain and the expected changes after a pneumonectomy. A case example is presented of a patient who has recently undergone pneumonectomy, detailing aspects of the case such as the chest X-ray (CXR) on the day of surgery, as well as postoperative day (POD) one and two. The discussion also notes the differences observed in the hemidiaphragm between POD one and POD five.  

Finally, they address potential complications that can occur after pneumonectomy and emphasize essential nursing interventions to mitigate these risks. These include strategies for preventing infection, effective pain management, and cardiac monitoring. 

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