3 Oxygenation.docx - Lecture Notes NURS 360 Oxygenation Diagnostic Tests Bronchoscopy Flexible fiberoptic bronchoscope Remove foreign body(if lung

3 Oxygenation.docx - Lecture Notes NURS 360 Oxygenation...

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Lecture Notes NURS 360 Oxygenation Diagnostic Tests Bronchoscopy Flexible fiberoptic bronchoscope Remove foreign body (if lung cancer), needle aspiration -biopsy mass, cell brushing (tissue samples-diagnosis of lung cancer) Prep Informed consent (doctor’s responsibility) can’t consent if received narcotics Name, DOB Vitals (RR, o2sat) Allergies Basic assessment of lungs Have pt void Remove dentures PTT- may accidentally knick Let pt know- throat will be sore after, will give lidocaine spray, may cough up blood HOB elevated, NPO till gag reflex returns (usually 2 hours) Complications Bleeding Aspiration Lyrengeal spasm from edema-may cause stridor cough Pneumothorax Cranial nerve XII-hypoglossal- have pt stick tongue out and move side to side Chest X-ray PA (posterior to anterior), AP (anterior to posterior), or Lateral o Pneumonia, TB, rib fractures, pneumothorax CT: Computed tomography- more detailed Shows discrete cross –sectional layers Aids in dx: lung tumors, and emboli MRI: Magnetic resonance imaging Shows cross sectional layers of anatomical structures by means of magnetic energy exposure, revealing tumors, vascular abnormalities and infections MRA: angiography- add dye V/Q scan: ventilation/perfusion Shows the movement or lack of movement of air in the lungs and the blood supply to specific lung areas The ventilation part of the test looks at the ability of air to reach all parts of the lungs 1
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Lecture Notes Perfusion part evaluates how well blood circulates within the lungs Lung Volumes and Capacities PFT (pulmonary function tests) Spirometry Evaluates the air capacity of the lungs Tidal Volume: the amount of air normally inhaled (or exhaled) with each average breath. This is about 500ml Inspiratory reserve volume IRV: The extra amount you could have forced inhaled after breathing normally Expiratory reserve volume ERV: the extra amount you could have forced exhaled after exhaling normally. Functional Residual Capacity: The residual left in the lung after a normal expiration (indicates air trapping- increased with COPD) Vital Capacity VC: Test of breathing capacity – the total volume of air that can be exhaled during maximal expiration (@4.8 L) It gives useful info about the strength of respiratory muscles FEV 1 : Timed vital capacity: The fraction of the vital capacity expired during the first second of a forced expiration FEV1/ FVC The FEV1/FVC ration is the ratio of the forced expiratory volume in the first one second to the forced vital capacity of the lungs. The normal value for this ratio is above 0.70, though this is age dependent varying between 0.70 and 0.90 Values less than 0.70 are suggestive of airflow limitation with an obstructive 2
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Lecture Notes pattern.
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  • Spring '16
  • Kim McCarron

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