1. Explain about epidermoid carcinoma?

Answer: a malignant lung tumor in the lung tissue, lung cancer is an abnormality of the cells – cells that have proliferation in the lung.

2. What can cause epidermoid carcinoma?

Answer: Smoking is prolonged, irradiation, lung cancer caused by work, the air population, Genetic.

3. How do I pengobatanya?

Answer: Done Chemotherapy, Radiology, Radiation (X-ray)

4. Symptoms of what is present in patients with epidermoid carcinoma?

Answer: Symptoms – symptoms may include cough, hemoptysis, dispneu, fever and unilateral dingin.Wheezing can terdengan on auscultation.

5. There are some types of radiotherapy mentioned?

Answer: There are two kinds: 1. Symptoms – symptoms may include cough, hemoptysis, dispneu, fever, and unilateral dingin.Wheezing can terdengan on auscultation.
2. Internal Radiotherapy (Radioisotope Therapy (RIT))
Radiotherapy is given through the intravenous fluid and then into the blood vessels or can also be a way to swallow it.

6. Please list the various carcinoma?

Answer: cervical carcinoma, vulva carcinoma, Bronkogenik carcinoma, mammary carcinoma, large cell carcinoma, small cell carcinoma, etc..

7. State the early symptoms and general symptoms that looked at patients with carcinoma?

Answer: 1. Local awal.Stridor symptoms and mild dyspnea that may be caused by bronchial obstruction.
2. Common symptoms.
a. Cough
Due probably to the irritation caused by the tumor mass. Cough began as a dry cough without sputum formed, but evolved to the point where the formed thick and purulent sputum in respond to secondary infections.

b. Hemoptysis
Sputum Sputum faintly through the surface of blood because the tumors ulcerated.
c. Anorexia, fatigue, weight loss.

8. What can be done on the examination Diagnotik? Please list and explain!

Answer:
1. Radiology.
a. Photo thorax posterior – anterior (PA) and leteral and chest tomography.
Is a simple initial examinations that can detect lung cancer. Describe shapes, sizes and location of the lesion. Can express air mass at the hilum, pleural effuse, atelectasis rib or vertebral erosion.
b. Bronkhografi.
To see the tumor in the branching bronchus.
2. Laboratory.
a. Cytology (sputum, pleural, or lymph nodes).
Conducted to assess the presence / stage carcinoma.
b. Examination of lung function and GDA
Can be conducted to assess the capacity to meet the needs of ventilation.
c. Skin tests, the number of absolute lymphocytes.
Can be conducted to evaluate the immune competence (common in lung cancer).
3. Histopathology.
a. Bronchoscopy.
Allows visualization, washing section, and cleaning of cytologic lesions (carcinoma bronkogenik magnitude can be known).
b. Trans biopsy Torakal (Lp).
Biopsy with Lp especially for lesions located peripheral to the size <2cm, sensitivity reached 90-95%.
c. Torakoskopi.
Pleural biopsy tumor area gives better results by torakoskopi.
d. Mediastinosopi.
Umtuk obtain tumor metastasis or lymph nodes are involved.
e. Thoracotomy.
Totakotomi for lung cancer diagnostic is done when the noise – kind of non-invasive and invasive procedures previously failed to obtain tumor cells.
4. Imaging.
a. CT-scanning, to evaluate the pulmonary parenchyma and pleural tissue.
b. MRI, to show the state of the mediastinum.

9. State the purpose of treatment in carcinoma?

Answer:
a. Curative
Prolong disease-free period and increase the client’s life expectancy.
b. Palliative.
Reducing the impact of cancer, improve the quality of life.
c. Rawat home (Hospice Care) in terminal cases.
Reducing the physical and psychological impact of cancer on patients and families well.
d. Supotif.
Supporting the curative treatment, palliative and terminal sepertia nutrition, blood transfusion and blood components, drugs to treat pain and anti-infection.

10. Complications of what happens at an advanced stage?

Answer: At an advanced stage, weight loss usually indicates the existence of metastases, particularly in the liver. Lung cancer can bermetastase into the structure – such as the lymph nodes nearby structures, the walls of the esophagus, pericardium, brain, bone frame.

11. What is the use CT-scanning imaging?

Answer: to evaluate the lung parenchyma and pleural tissue.

12. What is the use of MRI imaging?

Answer: to show the state of the mediastinum.

13. Say what differential diagnosis of carcinoma?

Answer: This carcinoma originating from the surface of bronchial epithelium. Epithelial changes including metaplasia, dysplasia caused by smoking or long-term, typically precedes the emergence of tumors. Located around the central hilum, and protruding into the major bronchi. Tumor diameter rarely exceeded a few centimeters and tends to spread directly into the hilum of the lymph nodes, chest wall and mediastinum.

14. Why smoking may cause any known epidermoid carcinoma?

Answer: No doubt a major factor. A definitive statistical relationships has been done between regular smokers (more than twenty cigarettes a day) from lung cancer (ma karsino bronkogenik). Smokers have great r ten times greater than light smokers.

15. There are some genes that play a role in epidermoid carcinoma! Mention?

Answer: There are three, namely: a. Proton Oncogene.
b. Tumor suppressor gene.
c. Gene encoding an enzyme.

16. State the pathophysiology of epidermoid carcinoma?

Answer: From etiology that attacks branching segments / sub bronchus cause cilia loss and deskuamasi resulting in the deposition of carcinogens. With the deposition of carcinogens will cause metaplasia, hyperplasia and dysplasia. When the peripheral lesions caused by metaplasia, hyperplasia and dysplasia penetrating pleural space, usually arising from pleural effusion, and can be followed by direct invasion to the ribs and the corpus verterbrai. Lesions of the central location comes from one of the largest branch of the bronchus. These lesions cause obstuksi and ulceration, followed by the bronchus with the distal supurasi.

17. What is a large cell carcinoma?

Answer: It is a cell – a large malignant cells and very poorly differentiated with large cytoplasm and nucleus size range – range. Cells – these cells tend to occur in lung tissue – peripheral lung, grows rapidly with extensive and rapid deployment to places – places far away.

18. What purpose do surgery on patients with epidermoid carcinoma?

Answer: The purpose of the surgery of lung cancer the same as other lung diseases, for pick-up all diseased tissues while maintaining as much lung function – which is not affected by lung cancer.

19. Why do chemotherapy in patients with carcinoma Epidemoid?

Answer: Chemotherapy used to disrupt the pattern of tumor growth, to treat patients with small cell lung tumors or with the wider community and to complement metastasi surgery or radiation therapy.

20. What is the difference of Chemotherapy and Radiotherapy? Explain!

Answer: Kemoterapa is a disturbing pattern of tumor growth, to treat patients with small cell lung tumors or with the wider community and to complement metastasi surgery or therapy radiasi.dan if Radiotherapy is the use of radiation to destroy or damage cancer cells so that cells can no longer multiply. Although this radiation will hit the entire cell, but generally normal cells more resistant to radiation compared with cells kanker.6, 7.

21. Describe the usefulness of the Radiotherapy?

Answer: • Treat: many cancers can be cured by radiotherapy, either with or without combination with other treatments such as surgery and chemotherapy.
• Control: If it is not possible anymore of healing, radiotherapy is useful for controlling the growth of cancer cells to make cancer cells become smaller and stop spreading
• Reduces symptoms: In addition to controlling cancer, radiotherapy can reduce the symptoms commonly occur in cancer patients such as pain and also makes patients more comfortable life.
• Assist other medications: especially post surgery and chemotherapy are often referred to as “adjuvant therapy” or adjunctive therapy with the aim of surgical therapy and chemotherapy are given more effective.


REFERENCES

1. Long C, Barbara, Medical Surgical Nursing, Volume 2, Bandung, Foundation for Nursing Education Alumni Association Pajajaran, 1996
2. Tuti Pahria, et al, Nursing Care on Patients with the disorder Persyarafan System, Jakarta, EGC, 1993
3. Medical Education Center Health Department, Nursing Clients Impaired Innervation Systems, Jakarta, MOH, 1996
4. Smeltzer C. Suzanne, Brunner & Suddarth, Medical Surgical Nursing Textbook, Jakarta, EGC, 2002

2. sjamsuhidayat, R. II. Wim de Jong, Textbook Surgery, Revised Edition, Jakarta, EGC, 1997

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