Med-Surg-Respiratory Flashcards
_________________ are used to evaluate a client’s respiratory status by checking indicators such as the oxygenation of the blood, lung functioning, and the integrity of the airway.
Respiratory diagnostic procedures
Respiratory diagnostic procedures that nurses should be knowledgeable about include the following:
Pulmonary function tests (PFTs)
ABGs
Bronchoscopy
Thoracentesis
Insertion of a ______________ into the pleural space is a therapeutic procedure that allows fluid, blood, or air to drain.
chest tube
reestablishes negative pressure,, facilitates lung expansion and restores normal intrapleural pressure.
chest tube
Where can a provider perform the insertion of a chest tube?
emergency department, client’s bedside, or in the operating room
When does the provider remove the chest tube?
when the lungs have re-expanded and/or there is no more fluid drainage.
Pulmonary function tests determine:
lung function and breathing difficulties
____________ measure lung volumes and capacities, diffusion capacity, gas exchange, flow rate, airway resistance, and distribution of ventilation.
PFTs
How long do you refrain from smoking before a PFT?
6-8 hours
How long do you withhold the use of inhalers before a PFT?
4-6 hours
A ____sample reveals the status of oxygenation and acid-base balance of the blood.
ABG
the amount of free hydrogen ions in the arterial blood (H+)
pH
the partial pressure of oxygen.
PaO2
the partial pressure of carbon dioxide
PaCO2
the concentration of bicarbonate in arterial blood
HCO3 -
percentage of oxygen bound to Hgb as compared with the total amount that can be possibly carried
SaO2
An RN or respiratory therapist can obtain and ABG sample by an arterial puncture or through an
arterial line
Blood ____ levels can be affected by any number of disease processes (respiratory, renal, malnutrition, electrolyte imbalance, endocrine, or neurologic.
pH
______ data is helpful in assisting in monitoring the effectiveness of various treatments (such as acidosis interventions), guiding oxygen therapy, and collecting data about client responses to weaning from mechanical ventilation.
ABG
expected range of pH from ABG
7.35 - 7.45
expected range of PaO2 from ABG
80-100 mm Hg
expected range of PaCO2 from ABG
35-45 mm Hg
expected range of HCO3- from ABG
21-28 mEq/L
expected range of SaO2 from ABG
95% - 100%
blood pH levels below 7.35 from ABG reflect
acidosis
blood pH levels about 7.45 from ABG reflect
alkalosis
complications of an ABG are?
Hematoma, arterial occlusion, air embolism
what is it called when blood accumulates under the skin at the IV site
hematoma
nursing actions for a hematoma at the IV site to obtain an ABG?
Observe for changes in temp, swelling, color, loss of pulse, or pain. Notify charge nurse or provider immediately if symptoms persist, apply pressure to the hematoma site.
During an ABG if air enters the arterial system upon catheter insertion it is called?
an air embolism
what are the nursing actions for an air embolism?
place the client on his left side in the trendelenburg position, monitor the client for a sudden onset of SOB, decrease in SaO2 levels, chest pain, anxiety and air hunger. notify the charge nurse or provider immediately if symptoms occur, administer oxygen therapy, assist in obtaining ABGs, continue to collect data about the clients respiratory status for any deterioration.
______________ permits visualization of the larynx, trachea, and bronchi through either a flexible fiber optic bronchoscope or a rigid bronchoscope.
bronchoscopy
In what settings can bronchoscopy can be performed:
outpatient procedure, surgical suite under general anesthesia or at the bedside under local anesthesia and moderate (conscious) sedation.
bronchoscopy can be performed on clients who are receiving mechanical ventilation by ins3erting the scope through _________________
the clients endotracheal tube
