unit2 respiratory 6q

Question 1

What are changes in the respiratory system associated with aging?

Answer 1

● Exercise tolerance decreases
● Airways lose cartilage and elasticity
● Response to hypoxia and hypoxemia decreases
● Increase in the anteroposterior diameter of the chest- barrel chest
● Increased vascular resistance
● Decreased pulmonary capillary flow
● Decreased function of cilia
● Decreased alveolar surface area
● Decreased elastic recoil
● Increased residual lung volume
● Decreased vital capacity
● Decreased gas exchange

Question 2

What are some other important assessments specific to respiratory?

Answer 2

● Allergies
● Drug use
● Cough
○ Productive, non-productive, color, amount
● Skin
● Endurance/ ADL’s
● Anxiety

Question 3

What assessment finding is an objective sign of chronic oxygen deprivation?

Answer 3

● Clubbing of fingernails and a barrel-shaped chest

Question 4

What are some other labs and imaging assessments to evaluate?
● Sputum
● WBC with Diff
● ABG
● Chest X-ray
● CT chest

Answer 4

● Sputum
○ Culture and sensitivity
○ Cytology

● WBC with Diff
○ Indication of infection

● ABG
○ Data on oxygenation as well as acid base balance

● Chest X-ray
○ Very common diagnostic tool
○ Typically one of the first tools

● CT chest
○ With contract or without

Question 5

What is a pulse oximeter used to measure?

Answer 5

● Hemoglobin saturation

Question 6

What diagnostic test has the highest risk of for the post-procedure complication pneumothorax?

HIGHEST R/F PNEUMOTHORAX

Answer 6

● Lung biopsy

Question 7

Laryngoscopy- Scope inserted into larynx to assess the function of the vocal cords

What’s the use of :

Answer 7

○ Uses-
■ Remove foreign bodies caught in larynx
■ Obtain tissue samples for biopsy or culture

Question 8

Mediastinoscopy- Insertion of a flexible tube through the chest wall just above the
sternum into the area between the lungs

○ Uses- ???
○ Performed under general anesthesia

Answer 8

○ Uses-

■ Examine for tumors
■ Obtain tissue samples for biopsy or culture
○ Performed under general anesthesia

Question 9

Bronchoscopy- Insertion of a tube in the airways, usually as far as the secondary bronchi
○ Use for ??

Answer 9

○ Use-
■ View airway structures
■ Obtain tissue samples for biopsy for culture
■ Remove excessive secretions or foreign bodies
■ Assist with placing or changing an endotracheal tube

Question 10

For BRONCHOSCOPY

RN Interventions Post Procedure-

Answer 10

■ Monitor VS, O2 saturation, and breath sounds every 15 minutes for 2
hours.
■ Assess LOC, presence of bleeding, ability to talk
■ Monitor return of gag reflex
■ Chest X-ray
■ Assess for possible complications of bleeding, infection, or hypoxemia

Question 11

Thoracentesis- Needle aspiration of pleural fluid or air from the pleural space for diagnostic or
management purposes

Use for what and what to know.

Answer 11

● Often performed at the bedside
● Local anesthetic agent to numb area
● Help to position the patient- Sitting up, leaving over a bedside table
● Stress the importance not to move, cough, or deep breath during the procedure

Question 12

For THORANCENTISIS

● RN Interventions Post Procedure-

Answer 12

○ CXR to rule out possible pneumothorax (can occur within 24 hours)
○ Monitor VS, lung sounds, bleeding at the puncture site

Question 13

Lung Biopsy- Performed to obtain tissue for histologic analysis, culture, cytologic examination
● May be performed-

Answer 13

○ In radiology department with help of fluoroscopy or CT
○ In OR if an open biopsy required under general anesthesia
○ Through bronchoscopy

Question 14

LUNG BIOPSY

● RN Interventions Post Procedure-

Follow up care for

Answer 14

○ CT of CXR to rule out pneumothorax
○ Follow up care-
■ Assess VS, breath sounds Q4h for 24 hours
■ Assess for respiratory respiratory distress
■ Report reduced/absent breath sounds immediately
■ Monitor for hemoptysis- bloody sputum