resp system- 2

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  1. Ventiliation-Perfussion (VQ) scan
    • ventilation- inhaled radioactive gas
    • pefusion- radiologic contrast injected IV
    • used to r/o PE
    • CXR- PA, AP, lateral
    • US
    • CT scan
    • MRI
  2. Bronchoscopy
    • remove deep lung secretions (snake like instrument)- obtain biopsies
    • NPO 6 hours before
    • nsg care after- close VS, monitor for resp distress, hemoptysis, NPO until gag reflex, check CXR results, inc swallowing could be bleeding
  3. Pulmonary angiography
    • constrast injected IV to examine pulmonary vasculature
    • most of the dye is tracked by a series of xprays
    • used to r/o PE- more invasive than VQ scan
    • nsg same is cardiac cath
    • - wacth site for bleeding, discomfort, VS, labs- lytes
  4. Sputum collection
    • before Abx (antibiotic) when possible (TB)
    • brush teeth, clean mouth before
    • first thing in the AM, esp AFB0 acid fast bacillus
    • may need NTS- nose throat swab (with order) to obtain
    • assess pre/post procedure
    • note color, consistency, odor, amount
  5. Thoracentesis
    • drainage of fluid or air from pleural space
    • therapeutic or diagnostic
    • local anesthesia
    • manual or vacuum drainage
  6. Thoracentesis procedure- nursing
    • before during
    • before: position pt- upright, over table
    • - if unstable, recumbent with arm over head
    • - sedation PRN
    • During:
    • - monitor VS
    • - observe for SOB, dyspnea, CP
    • - assist the provider PRN
  7. Thoracentesis procedure
    • after
    • position on unaffected side for 1 hour
    • frequent VS- hemodynamic
    • frequent breath sounds- escaped air
    • report diminished breath sounds & tachyapnea- immediate***
    • monitor for pneumothorax
    • - CXR (if +, possibly chest tube insertion)
    • record amount & color drainage
    • assess for subcutaneous emphysema- crepitus - crackles
    • maintain DSD, dry x 3D
    • rate and depth will tell you about CO2

Card Set Information

Author:
Prittyrick
ID:
327923
Filename:
resp system- 2
Updated:
2017-01-30 18:48:19
Tags:
diagnostic
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Description:
diagnostic
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