Wk 1 Respiratory Labs and Diagnostics Flashcards
What is oximetry referring to?
The amount of hemoglobin that is carrying oxygen
Decreased pulse ox could mean…
Hypoventilation, atelectasis, pneumothorax,
Oximetry is commonly used to __ oxygen levels in hospitalized patients
titrate
You can also put an pulse ox on an __ __ or __
ear lobe or toe
Three types of sputum tests
C&S, Cytology, and AFB (acid fast bacillus)
A C&S sputum should not be…
saliva
A C&S sputum should be from where?
The throat
What time is best to get a C&S sputum?
Early am
For a chest x-ray, the patient needs to remove the metal on their body from where?
Between neck and waist
What does CT scan stand for?
Computed tomography
Describe the experience of the CT scan
Hard table, scanner revolves around body, and makes a clicking sound
CT scans can be with or without
contrast
What is contrast?
A medium that is injected into the patient’s IV to help highlight their internal structures
Contrast is typically __ based
Iodine
Contrast is nephro__
nephrotoxic, hard on the kidneys
Two labs you need to look at if a patient is going for a CT with contast
creatinine and BUN
A way you can tell if a patient might have a reaction to the iodine-based contrast for a CT is by asking them what?
If they are allergic to shellfish
When the contrast is injected the patient will feel a __ __ all over their body
warm flush
What should you encourage after the CT and why?
Increased fluid PO intake to flush to contrast out of the kidneys
What does MRI stand for?
magnetic resonance imaging
What is a MRI used for?
Assess lesions that are difficult to asses by CT and for distinguishing vascular from nonvascular structures
MRI does use a __ medium
contrast
What is different about the contrast medium for MRI?
It’s not iodine based
If the MRI is “closed” what is a concern for the patient?
Claustrophobia
What is important to do before having an MRI?
Remove everything and anything metal
What does a PET scan stand for?
Positron Emission Tomography scan
How does a PET scan work?
It uses a radioactive substance called a tracer to look for lung disease/cancer
What is the difference between MRI/CT and a PET scan?
MRI/CT look at structure while a PET scan looks at function
Examples of things a PET scan can look for…
Blood flow, use of oxygen, uptake of sugar
A TB skin test is injection __
intradermally
What degree angle should you inject a TB skin test?
10-15 degrees
The solution for a TB needs to be in the __ and cause a __
epidermis, bleb
What is a bronchoscopy?
Scoping of the bronchi
Two reasons for a bronchoscopy
Obtain a biopsy or for treatment
What needs to be anesthetized for a bronchoscopy?
Naso and/or oropharynx
3 nursing care considerations for a patient before a bronchoscopy
Consent form, NPO for 6-12 hours, give sedation
3 nursing care considerations for a patient after a bronchoscopy
Keep NPO until gag reflex returns
Blood tinged mucus NOT abnormal
If biopsy done, monitor for hemorrhage or pneumothorax
What is the first sign of internal bleeding?
An increase in heart rate that is unexplained
What is the next best nursing action for a patient experiencing blood tinged mucous after a bronchoscopy?
Document the findings
What is a pneumothorax?
Collapsed lung
4 ways a lung biopsy can be taken
Bronchoscopy, transthoracic needle aspiration, open lung biopsy, VATS procedure
What is a VATS procedure?
Video assisted thoracic surgery
Where is a VATS procedure done?
OR
Where is an open lung biopsy done?
OR
Where is a transthoracic needle aspiration done?
Radiology with CT guidance
Where is a bronchoscopy done?
Endoscopy suite
What is a cystoscopy?
Scoping of the bladder
What is a pleural effusion?
Build-up of excess fluid between the layers of the pleura outside the lungs
What is the treatment for a pleural effusion?
Thoracentesis
3 reasons for a thoracentesis
obtain fluid for diagnosis, remove pleural fluid, instill medication
What do they do during a thoracentesis?
Insert a large bore needle into the pleural space
What is the problem with a pleural effusion?
Impacts surface area for oxygen delivery
What is third spacing?
accumulation of fluid from the blood within body cavities, intestinal areas, or areas of the body that normally contain little or no fluid.
3 nursing considerations before a thoracentesis
consent form, patient upright with elbows on overhead table in room, instruct not to talk
Nursing care after thoracentesis
Chest x ray and assess for hypoxia and pneumothorax
During a pulmonary function test, most patient have their nose
pinched
Maximum amount of air expelled forcefully in 1 second is what?
forced expiratory volume or FEV1
Who has a problem pushing air out?
COPD patients!
The FEV1 on a patient with COPD would be…
lower
What is a peak flow meter?
It’s used in asthma patients to assess for early asthma attack. Measures their FEV1
