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Content Approach

Content Approach. Anatomy & Physiology Review Demographics/occurrence Pathophysiology Clinical Picture Medical Management Nursing Process (APIE) Assessment - Nursing Actions - Education. Alterations in Ventilation Diagnostic Studies. Blood Studies : CBC Arterial Blood Gases

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Content Approach

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  1. Content Approach • Anatomy & Physiology Review • Demographics/occurrence • Pathophysiology • Clinical Picture • Medical Management • Nursing Process (APIE) Assessment - Nursing Actions - Education

  2. Alterations in VentilationDiagnostic Studies • Blood Studies: • CBC • Arterial Blood Gases • Sputum Studies: • Gram Stain / Culture & Sensitivity • Acid-fast smear • Cytology

  3. Diagnostic Studies • Radiology: • Chest x-ray-- posterior-anterior / lateral • Computed tomography (CT) – cross sections of the lung with and without contrast – used often • Pulmonary angiogram – x-rays after injection of radiopaque dye– used to diagnose pulmonary embolism • Positron emission tomography (PET) – IV glucose administration – malignant tumors show increased uptake of glucose • Ventilation-Perfusion Scan – Perfusion: isotope administration which outlines pulmonary vasculature; Vent: inhalation of radioactive gas which outlines the alveoli – pulmonary emboli

  4. Alterations in VentilationDiagnostic Studies • Pulmonary Function Testing • tests to measure lung volumes and used to diagnose pulmonary disease, monitor progress, evaluate disability, evaluate response to bronchodilators – done in pulmonary lab • Skin Testing • intradermal planning of test dose to assess skin reaction by measuring mm induration – TB, various lung diseases

  5. Pulmonary Function Test Relationship of Lung Volumes & Capacities

  6. Alterations in VentilationDiagnostic Studies • Endoscopic Exams (done in x-ray or OR): • Bronchoscopy – fiberoptic visualization of bronchi – biopsy; to remove mucous plugs, foreign bodies, obstructions • Mediastinoscopy – scope through a small incision n the suprasternal notch – visualize mediastinum for tumors, lymph nodes, infections, sarcoidosis • Biopsy:Transbronchial or open lung biopsy – done in OR or X-ray • Thoracentesis– insertion of a needle into the pleural space – pleural fluid, install medication - done at bedside

  7. Respiratory Diagnostic Testing Fiberoptic Bronchoscopy

  8. Care of the patient undergoing Bronchoscopy • Pre-Procedure: • Explanation & consent • CBC, platelet count, INR, chest x-ray • Post-Procedure: • Post anesthesia recover room procedures • Stable vital signs • Airway management • Return of gag reflex • Assess: breath sounds, pulse oximetry, • Complications: • Hypoxemia • Bleeding (hemoptysis) • infection

  9. Diagnostic Lung Tests Thoracentesis

  10. Care of the Patient undergoing Thoracentesis • Pre-Procedure: • Explanation & consent - timeout @ bedside • CBC, platelet count, INR, chest x-ray • During Procedure: • Tripod position – no movement during procedure • Local anesthetic – aseptic technique • Monitor for dyspnea, tachypnea, pain, pallor, diaphoresis, shock • Post-Procedure: • Vital signs, ascultate breath sounds, chest x-ray • Check puncture site for leakage or bleeding • Complications: • Pneumothorax and mediastinal shift

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