1 / 42

Respiratory Assessment: Tools and Methods for Effective Evaluation

Learn about assessing breathing ability through pulmonary function tests, pulse oximetry, radiographic exams, and lab values. Understand the purpose of each test, their management, and interpretation of key lab values.

adonis
Download Presentation

Respiratory Assessment: Tools and Methods for Effective Evaluation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Respiratory Assessment Lecture 2b

  2. Assessment of breathing ability • Pulmonary function test • Pulse oximeter • Radiographic exams • Lab values

  3. Pulmonary Function Tests Purpose • Assess resp. function • Tidal volume • Vital capacity • Rate • Inspiratory force • Progress of disease

  4. Pulse Oximeter Purpose • Noninvasive O2 Sat Normal • 95-100% • <85%  • Tissue is not receiving enough O2

  5. Pulse oximeter Not reliable in… • Cardiac arrest • Shock • Vasoconstrictive meds • Dyes • Anemia • High CO levels

  6. The most appropriate nursing intervention for a client requiring a finger probe pulse oximeter is to: • Apply the sensor probe over a finger and cover lightly with gauze to prevent skin breakdown • Set alarms on the oximeter to at least 100% • Identify if the client has had a recent diagnostic test using intravenous dye • Remove the sensor between oxygen saturation readings

  7. Radiographic exams • Chesk x-ray • CT scan • PET • Fluroscopy • Barium Swallow • Angiography • Bronchoscopy • Thoracoscopy • Thoracentesis

  8. Chest x-ray Description • 2-d image Purpose • Fluid • Tumor • Foreign bodies

  9. Chest – X-ray Nrs management • Call pink ladies • Normal heart size & clear lung field

  10. CT Scan Description • Computerize Tomography • With or without contrast medium Purpose • Tissue • Tumor • Foreign bodies • Fluid

  11. CT scan Nrs management • Without contrast medium • No prep • With contrast medium • NPO 6 hrs • Assess for allergies

  12. Positron Emission TomographyPET Purpose • Confirm adequate blood supply Description • Radioactive tracers injected IV

  13. Fluoroscopy Purpose • Detect movement • Diaphragm paralysis Description • X-ray

  14. Barium Swallow Purpose • View esophagus and cardiac sphincters Description • Drink barium • X-ray

  15. Barium swallow Nrs Management • NPO • Post-procedure • Laxatives • BM  white

  16. Angiography Purpose • Pulm. Circulation Description • Dye • Femoral vein  • Heart  • Pulm Arteries

  17. Angiography Nrs. Management • Pre-op • NPO • Check Allergies • Shellfish/iodine • Post-op • Lie flat 8 hrs • Sandbag • Check pedal pulses • Assess hemorrhaging • Push fluids • Normal pulmonary angiography

  18. Bronchoscopy Description • Direct inspection of larynx, trachea & bronchi via flexible tube (fiberoptic) Purpose • Examine • Tissue sample

  19. Bronchoscopy • Nrs Management • Pre-op • NPO 6-8 hrs • Sedation • i vegal response • i cough/gag reflex • i anxiety

  20. Bronchoscopy Nrs management • Post-op • Side-ling until gag back • NPO till gag back • Check gag • Check bleeding

  21. Thoracoscopy Description • Fiber-optic inspection of thoracic cavity • Incision Purpose • Inspect • tissue sample

  22. Thoracentesis Purpose • Remove fluid for dx • Remove fluid for tx • Obtain biopsy • Instill meds

  23. Thoracentesis Nrs Management • Position patient • Support • Post-op • Vital signs q 15 • Chest x-ray • Breath sounds – bilateral • Cover site • Check bleeding • Check drainage

  24. Lab Values • Sputum • WBC • Hemoglobin • Hematocrit • ABG’s • PTT/PT

  25. Sputum studies • Check for • Pathogens • C&S • Acid-fast bacillus • What? • TB • Duration • 4-6 wks

  26. White Blood Cell Count • Normal • 5,000 – 10,000 cell/mm3 • Elevated • Bacterial infection • Decreased • Leukemia • Viral infection

  27. Hemoglobin Normal • Female: 12-16 g/dl • Male:14-18 g/dl Elevated • COPD • Dehydration Decreased • Anemia • Hemorrhaging • Over hydration

  28. Hematocrit Normal • Female: 37-47% • Male: 42-52% Elevated • Dehydration • Burns • COPD Decreased • Anemia • Leukemia

  29. Arterial Blood Gases Purpose • Adjust O2 levels • Hypoxemia Description • Must by arterial blood

  30. Arterial Blood Gases Values • pH • PaO2 • PaCO2 • HCO3- • SaO2

  31. ABG’s pH • Normal • 7.35-7.45 • Elevate • > 7.45 • Alkalosis • Decreased • <7.35 • Acidosis

  32. pH Quiz: Acidosis or alkalosis • Arterial blood pH of 7.51? • Alkalosis • Arterial blood pH of 7.30? • Acidosis • Arterial blood pH of 7.34 • Acidosis • Arterial blood pH of 7.43 • Normal / homeostasis

  33. ABG’s • PaO2 • Normal • 80-100 torr • Elevated • Hypervenilation • Decreased • i resp. function • Hypoxemia

  34. ABG’s PaCO2 • Normal • 35-45 mmHg • Elevated • Hypercapnia • Impaired gas exchange • Decreased • Hyperventilation

  35. ABG’s HCO3- • Normal • 22-26 SaO2 • Normal • 95-100% • Decreased • Hypoxemia

  36. PTT/PT Partial Thromboplastin Time • Prolonged • Liver disease • Vit K deficiency • Anticoagulant • Hemophilia

  37. Quiz? • The main function of platelets is to… • Provide oxygen to tissue • Fight viral infections • Fight bacterial infections • Form a blood clot

  38. A fragile 87 year-old female has recently been admitted to the hospital with increased confusion and falls over last 2 weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed? • FBC (full blood count) • ECG (electrocardiogram) • Thyroid function tests • CT scan

  39. A 84 year-old male has been loosing mobility and gaining weight over the last 2 months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed? • FBC (full blood count) • ECG (electrocardiogram) • Thyroid function tests • CT scan

  40. A 20 year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first? • Blood sugar check • CT scan • Blood cultures • Arterial blood gases

  41. A 28 year old male has been found wandering around in a confused pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first? • Blood sugar check • CT scan • Blood cultures • Arterial blood gases

  42. A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long to RBC’s last in my body? The correct response is. • The life span of RBC is 45 days. • The life span of RBC is 60 days. • The life span of RBC is 90 days. • The life span of RBC is 120 days.

More Related