Advanced Nursing Skills 1: Respiratory Procedures

Question 1

Explain the various respiratory procedures and identify clients who would benefit from it. State the nurse’s role for each

Answer 1

• Deep Breathing Exercises
• Incentive Spirometer
• Humidifier & Supplemental Oxygen
• Postural Drainage
• Tracheostomy Care
• Nose & Throat Specimens

Question 2

What are some bronchoscopy pre-procedures according to the powerpoint?

Answer 2

• Informed consent needed.
• Explain procedure to client.
• Must be NPO 6 to 8 hours before procedure.
• Local or generalized anesthesia used.
• Receives atropine to dry secretions.
• Receives sedative or narcotic to depress vagus nerve

Question 3

What are some bronchoscopy pre-procedures according to the powerpoint?

Answer 3

• Assess for gag reflex.
• Keep NPO until client has a gag reflex.
• Assess for dyspnea or bleeding.
• Keep an endotracheal tube at bedside.
• Position client on his or her side.
• Give pain medication if necessary for soreness.
• After gag reflex returns, offer liquids and then advance to soft foods.
• Patient should rest for at least 24 hours

Question 4

What are some additional Oxygenation Techniques?

Answer 4

• Water-Seal Chest Tube Drainage
  
  • Technique for evacuating air or blood from the pleural cavity, which helps restore negative intrapleural pressure and re-inflate the lung.
• Chest tubes are connected to the drainage system.
  
  • Drainage system must remain closed
    
    • Pleur-evac

Question 5

What is nursing care for a client with a chest tube?

Answer 5

• Assess lung sounds
• Ensure drainage system is placed below level of insertion.
• Tubing is non-obstructed.
• Encourage client to cough & deep breathe every 2 hours
• Never be separate tubing from system
  
  • Clamps at bedside.
• Monitoring of chambers
  
  • Collection
    
    • Mark drainage level at end of each shift
  • Water seal
    
    • Tidaling of water, sterile h2o @ 2cm mark
  • Suction control
    
    • Regulate suction to produce gentle bubbling; add sterile water if evaporated

Question 6

What should a nurse considerations should a nurse implement?

Answer 6

• Maintain the integrity of the suction apparatus and water seal at all times.
• Refill the water chamber if the fluid level gets low.
• Report at once any client who complains of severe pain or dyspnea.
• Keep clamps at bedside
• If connection breaks, the closed system will be disrupted → this is an emergency!
  
  • Clamp chest tube STAT and summons for help