Alarcon, Phoemela E. (ASST.

LEADER)
Aggabao, Marizza
Fabon, Joanna
Gamalinda, John Gabriel, T.

Superior Vena Cava Syndrome (SVCS)

Catchillar, Aira Marie M.
Ramos,Mel Joy R.
Canela, Darlene A.
Rodriguez, Maria Micah G
Penarroyo, Darielle, Ryan (LEADER)
Mercado, Julia Jemelee L.

ONCOLOGY CASE 3

Large Cell Carcinoma Adenocarcinoma Squamous cell Carcinoma

A PET CT was done to identify the extent of
the lesion. Liver and lung involvement were
seen. Tumor in the chest is seen to be causing Small Cell Lung Non small Lung Cancer
Cancer(less common) (More common)
pressure on the superior vena cava. Patient
started to cough. Shortness of breath and
edema of the face and upper extremities were Primary Bronchogenic Carcinoma

noted. Spider web veins were seen on the

patient’s face and chest. Local/ metastatic growth in

ipsilateral lung apex

What is present with the client?

Map its occurrence. Manage the Problem. Disruption of structures adjacent
to superior pulmonary sulcus

1. Contrast Enhanced Computerized Tomography Extrinsic compression and obstruction of the Superior Vena
2. Mediastinoscopy Cava (SVC) by a mass in the mediastinum
Shortness of breath
Ineffective breathing pattern related to decreased
cardiac output to the lungs secondary to
Superior Vena Cava Syndrome Invasion of airways
obstruction of airway, as evidenced by shortness
causing obstruction Cough of breath and cough.

Impaired skin integrity related to vascular

insufficiency as evidenced by spider web veins. Slow down blood flow ↓ Cardiac output
through the SVC to lungs

Short-term Goals:
After 1 hour of nursing intervention, patient
Short-term Goals: will be able to demonstrate, verbalize and
After 1 hour of nursing intervention, the patient Spider web veins on the Lead to blockage understand proper deep breathing technique
will be able to verbalize the proper prevention face and chest of the SVC to facilitate proper oxygenation to alleviate
that can trigger the spider web veins. shortness of breath
After 1 hour of nursing intervention, the patient Long-term Goals:
will verbalize understanding of daily skin After 2-3 days of nursing intervention, the
inspection Venography patient will be free from cough and have a
Long-term Goals: Subsequent obstruction causes normal breathing pattern
After 3-4 days of nursing intervention, the increased venous pressure
patient will experience timely healing without
complications.

Results in
interstitial edema Edema on the face and Nursing Interventions:
Upper Extremity Venous Ultrasound
and retrograde upper extremities Independent
Nursing Interventions:
collateral flow Assess for concomitant pain/ discomfort that may restrict
Independent
Assess the client's understanding of the causes, treatment, respiratory effort.
and prevention of plan for spider web veins present. Note rate and depth of respirations.
Assess the overall condition of the skin Maintain the bed of the patient elevated or have the patient
Fluid volume excess related to excessive fluid
Advise patient to avoid direct sunlight and if unavoidable sit up in a chair, to promote proper lung expansion
buildup in the extracellular fluid space, as
sunscreen should be applied Observe characteristics of breathing patterns.
evidenced by edema on the face and upper
Advise patient to avoid vasodilators such as caffeine and Note presence and character of cough.
extremities
spicy food Maintain a patient airway and adequate oxygenation.
Instruct the client to take medications as indicated, Educate the patient on proper breathing, coughing, and
Nursing Interventions:
explaining their actions, dosages, and side effects. splinting techniques.
Independent

Dependent:
Assess the presence and location of edema.
Provide respiratory medication and oxygen, per doctor's
Dependent: Assess skin's overall condition, including its color, texture, Short-term Goals:
order.
Provide medications as prescribed and temperature. After 1 hour of nursing intervention, the patient
Provide supplemental fluids
Collaborative: Observe skin and mucous membranes. Edematous tissues will verbalize understanding of the factors that
Collaborative:
Consult dermatologists that treat spider veins and small are prone to ischemia and breakdown or ulceration. lead to fluid overload and will be able to
Refer the patient to a respiratory therapist.
varicose veins. Elevation of head end of bed to decrease the hydrostatic enumerate 2-3 dietary restriction
Consult a dietitian for dietary medications that can
pressure thereby the edema After 1 hour of nursing intervention, the patient
strengthen the functionality of respiratory muscles.
Monitor patient’s fluid intake and output. will verbalize causative factors and symptoms of
Refer the patient for evaluation of exercise potential and
Review nutritional issues. Imbalances are associated with the condition.
development of individualized exercise programs to promote
Retinoid fluid imbalances.
conditioning of respiratory muscles and patient's well-being.
Dependent: Long-term Goals:
Analgesics
Instruct patient on restricting fluid intake. After 2-3 days of nursing intervention, the patient
Administer medications per doctor’s order. will maintain an adequate fluid balance as
Collaborative: indicated by no peripheral edema, or neck vein
Consult dietitian as needed to develop dietary plan and distention.
identify foods to be limited and omitted.
Refer to the radiation oncologist.
Bronchodilators
Expectorant drugs

NSAIDs (such as ibuprofen and

naproxen)
Diuretics (furosemide)
Pramipexole (Mirapex)

Etiology Pathophysiology Clinical Manifestations Nursing Diagnosis Nursing goal Nursing Interventions Medications Diagnosis
 References:
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College of Angiology, Inc, 17(1), 43–46. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2728369/
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September 13, 2022, from https://www.healthline.com/health/mediastinal-tumor#diagnosis
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