NURSING 100 COTAC Final Exam Outline (AF)[5617] (1).docx
1. Respiratory Assessment and Care Modalities
a. Respiratory Assessment
• Health History-
... [Show More] Past Health, Social, and Family History
i. Physical Assessment
General Appearance
• Clubbing
• Cyanosis Upper Respiratory Structures
• Nose and Sinuses
• Trachea
Lower Respiratory Structures and Breathing
• Positioning
• Thoracic Inspection
• Thoracic Auscultation
• Anterior/Posterior
Wheeze
1. Lung Sounds
• Asthma & COPD
• Narrowing of Airway
Coarse Crackles
• PNA & Pulmonary Edema
ii. Diagnostics
PFT
PFT= Pulmonary Function Tests
Determine Lung Function and Breathing Difficulties
ABG’
Arterial Blood Gases (ABG)
Reports the Status of Oxygenation and Acid-Base Balance in the Blood
pH
PaO2
• Amount of H+
• Partial pressure of oxygen
PaCO2
• Partial pressure of carbon dioxide
HCO -
• Concentration of bicarbonate
SaO2
• Percentage of oxygen bound to HgB as compared to the total amount that can be carried
Bronchoscopy
Directly Examine Larynx, Trachea, Bronchi
Indications
• Visualize and Biopsy Tissue
• Visualize Inflammation or Strictures
• Aspirate Secretions, Sputum or Lung Abscesses
• Removal of Foreign Bodies
Considerations
• Pt is sedated and given anesthetic
• NPO 4-8 hours before exam
• ADAT after procedure when gag/cough reflex is present
Thoracentesis
Aspiration of Fluid from the Pleural Space
• Pleural Fluid Lubricates the Movement of the Lungs in the Thorax Indications
Sputum Cultures
• Empyema
• Pneumonia
• Best collected in the morning before the patient has had anything to eat or drink Use a sterile container
X- Ray
Patient Education=Contraindicated in pregnancy
• Patient needs to take a deep breath and HOLD it
Patient Preparation= Gown and take off jewelry/metal
• May use lead shield over thyroid, ovaries, and testicles
• Nurse should observe the three principles of time, distance, and shielding
CT
Patient Education= Contraindicated in allergy, pregnancy, morbid obesity
Patient Preparation= Must remain supine, sit still; NPO for 4 hours prior if contrast needed
MRI
Patient Education=Uses magnet and radiofrequency instead of radiation
• May also use contrast
• More detailed images
• Contraindicated in morbid obesity, claustrophobia, confusion/agitation, implanted metal
a. Some medical devices are okay Patient Preparation=Remove all metal, must lay flat and still
• OFFER EAR PLUGS
Pulse Ox
Noninvasive
• Measures oxygen saturation of hemoglobin
• Sensor can be placed on finger, forehead, earlobe, nare, lip, bridge of nose
Chest Tubes
2. Fluoroscopy
a. Patient Education
b. Patient Preparation
Water Seal=Allow excess air/fluid to exit pleural space with exhalation and stops air from entering with inhalation
c. Sterile Water at Bedside
3. Tidaling= expected
Bubbling=Air Leak in System
Indications=Pneumothorax
• Hemothorax
• Pulmonary Empyema
Complications=Air Leaks
• Do not d/c with air leak Accidental Disconnection
• Keep Sterile Water at Bedside
• Keep Occlusive Dressing at Bedside Tension Pneumothorax
• Clamped/Kinked Tubing
Removal=Pain Medication 30 Min Before
• Remove Sutures
• Patient will Valsalva
• Apply Airtight, Sterile Petroleum Jelly Gauze Dressing
• Obtain Chest X-Ray
• Monitor Wound Drainage [Show Less]