5 special resp care procedures

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Anonymous
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89638
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5 special resp care procedures
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2011-06-07 13:26:28
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special resp care procedures
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5 special resp care procedures
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  1. assessing and examining the bronchi which is used for therapeutic and diagnostic purposes
    brnchoscopy
  2. 2 types of bronchoscope
    • rigid
    • fiberoptic
  3. consist of a hollow metal tube with a light on its distal end
    rigid
  4. rigid bronchoscope is useful for
    • removing aspirated foreign bodies
    • thick secretions from the lungs
  5. consist of a collection of thing, threadlike glass strands called fiberoptic filaments with a light source profected to its distal end
    fiberoptic
  6. which bronchoscope is tolerated by pts
    fiberoptic
  7. what is the commonly sedative given to pt that needs bronchoscopy
    • diazepam-- valium
    • midazolam-- versed
  8. diazepam =
    valium
  9. midazolam =
    versed
  10. the level of sedation, referred to as
    conscious sedation, should be just enough to allow the pt to follow commands yet still be comfortable
  11. the airway must be dry during the procedure to air in visualization, which is usually achieved by administering
    • atropine, 1 to 2 hrs between procedure.
    • atropine may also decrease vagal tone, resulting dec potential for bradycardia and hypotension
  12. where can the tube be inserted
    • orally
    • nasally
    • throught the ett
  13. what is used both as lubricant and for anesthetic effects
    lidocaine-- xylocaine
  14. xylocaine =
    lidocaine
  15. indications for bronchoscopy
    • removal of foreign bodies
    • removal of mucu plugs and thick secretions
    • atelectasis that affects a lobe or entire lung
    • pulm hemorrhage
    • when tracheal intubation is difficult
  16. complications of bronchoscopy- 8
    • hypoxemia
    • laryngospasm
    • bronchospasm
    • arrhythmias
    • hemorrhage
    • resp depression
    • hypotension
    • pneumothorax
  17. used to drain substance that accumulate in the pleural space
    chest tubes
  18. what are some of the substances that can accumulate in the pl space
    • air
    • blood
    • lymph
    • serous fluid
    • pus
  19. air=
    pneumothorax
  20. blood-
    hemothorax
  21. lymph=
    chylothorax
  22. serous fluid-
    pl effusion
  23. pus-
    pyothorax or empyema
  24. ** to help evacuate air (pneumothorax) from the pleural space, the chest tube is usually inserted in the
    second, third, or 4th intercostal space
  25. ** to remove fluid, the tube is usually inserted in the
    placed lower, 6th or 7th intercostal space
  26. if the proximal hole on the chest tube slips out of the chest, air enters the tube resulting in
    bubbling in the system, which appears to be a persistent leak in the lung
  27. fluid or air drains from the pl space through the chest tube and enters the drainage bottle through a glass tube, which is submerged under water. this forms a seal that acts like a ONE WAY valve to prevent air from entering the pl cavity
    one bottle system

    (WATER SEAL AND DRAINAGE BOTTLE)
  28. collects air exiting the pl space. liquid drans into the first bottle. purpose of this system is to better control the amt of suction applied. suction source may be connected to the vent of the water seal bottle
    2 bottle system

    (WATER SEAL AND DRAINAGE BOTTLE & SUCTION CONTROL BOTTLE)
  29. determine the amt of SUBATMOSPHERIC PRESSURE in the water seal bottle. amt of suction is determined by how far under water the tube is submerged. suction source may be attached also
    3 bottle system

    (DRAINAGE BOTTLE & WATER SEAL BOTTLE & SUCTION CONTROL BOTTLE)
  30. what is the most commom chest tube drainage system
    pleur-evac = plastic threee chambered system
  31. what does it mean if theres no fuctuation occuring in the water seal bottle
    obstruction of the tube should be suspected
  32. obstructed chest tube may results in
    tension pneumothorax
  33. what should you do to ensure ADEQUATE drainage and TUBE PATENCY
    strip or milk the tube every 1 to 2 h
  34. occasional bubbling in the water seal bottle is
    normal as air enters from the pl space
  35. absense of bubbling indicates that
    no air is being removed from the pl space, which is a sign of the pts improvements
  36. if an air leak is suspected, the chest tube should be
    clamped to identify the source of the leak
  37. the glass tube MUST ALWAYS be kept
    submerged under the water

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