Resp. Flashcards
Pulmonary function test (PFT)
- Determined lung function and breathing difficulties
- measures: lung volumes/capacities, diffusion capacity, gas exchange, flow rates, airway resistance, Almog with distribution of ventilation
- performed to those who have dyspnea
- smokers: don’t smoke for 6-8 hours before
- inhalers: don’t use for 4-6 hours (varies
ABGs
- pH: amount of free hydrogen ions in the arterial blood
- PaO2: partial pressure of oxygen
- PaCO2: partial pressure of CO2
- HCO3: concentration of bicarbonate in arterial blood
- SaO2:
pH
7.35-7.45
Acidosis: below 7.35
Alkalosis: above 7.45
PaO2
80-100 mmhg
PaCO2
35-45mm Hg
HCO3
21-28 mm Hg
SaO2
95-100
Allens test
- prior to arterial puncture
- Clenches fist prior to arterial puncture while nurse puts pressure on radial and Ulnar arteries & then opens hand when instructed so. Hand show go from white to red=good circulation.
Bronchoscopy
Nurse action:
- Patient should be NPO 8-12 hours to prevent aspiration
- consent form
- remove dentures
- lidocaine or anesthetic throat spray
Intraprocedure:
- give meds as prescribed (anti anxiety, sedations, and /or atropine to reduce oral secretions
- sedation given to an older adult may cause resp. Arrest
Post procedure:
-Make sure swallowing and gag reflex is there before resuming oral intake( cannot be discharged from recovery from until these are recovered)
- a little blood in sputum is expected
- encourage deep breathing every 2 hours for older adults. Increased risk for infections.
Thoracentesis
-removal of air or fluid from the lungs.
-assessment:
Pain, S.O.B, cough, decreased breathe sounds, dull percussion sound, decreased chest wall expansion. Pain occurs due to inflammation
- nurse action:
- Informed consent
- X ray to determine needle site
- Patient should be sitting upright with *shoulders and arms raised with pillows
- assist doctor with tools
- comfort patient
- monitor vital signs
- measure fluid taken out of lung (1 L at a time is removed to prevent cardio vascular collapse)
Chest tube systems
- first chamber: drainage collection
- second chamber: water seal
- third chamber: suction control
Low oxygen flow delivery systems
- nasal cannula
- simple face mask
- partial rebreather mask
- nonrebreather mask
Chest tube insertion: nursing action
- consent form should be signed
- client teaching: breathing will improve when chest tube is in place
- assess for allergies and assist client into comfortable position
intraprocedure:
-chest tube tip is positioned up toward the shoulder
post:
- check water seal every 2 hours
- check vitals at least every 4 hours
- check the amount of drainage EVERY HOUR FOR THE FIRST 24 HOURS. Then every 8 hours after.
REPORT: greater than 70ml/hr or if drainage is red or cloudy
Complications of chest tube: Accidental disconnection
What do you do?
- Client should be instructed to exhale as much as possible and to cough to remove as much air as possible from the pleura space.
- Nurse should cleanse the tips and reconnect
- if drainage system is compromised, submerge the tube in sterile water to restore water seal (which is why equipment should always be in room)
- occlusive dressing taped on only three sides should be immediately placed over the insertion site.
Nasal cannula
FiO2- 24-44%
Flow rate: 1-6 L/min
