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ABGs can be obtained by an arterial puncture or through an arterial line. Interpretation of ABGs:oBlood pH levels less than 7.35 reflect acidosis, a pH level greater than 7.45 reflect alkalosis. ABG MeasureExpected Reference RangepH7.35 to 7.45PaO2 80 to 100 mm HgPaCO2 35 to 45 mm HgHCO3 21 to 28 mEq/LSaO295% to 100%Bronchoscopy Permits visualization of the larynx, trachea, and bronchi though either a flexible fiber-optic or rigid bronchoscope. oIndicated for visualization of abnormalities such as tumors, inflammation, and strictures.oBiopsy of suspicious lung tissueNursing Care:oMaintain patient at NPO 4 to 8 hours prior oPosition in sitting or supine position. oMonitor vitalsoPost procedure:Monitor vitals and asses LOC and gag reflex Complications can include: oLaryngospasm which is uncontrolled muscle contractions of the laryngeal cords that impede the ability to inhale.oPneumothorax which can occur following a rigid bronchoscopy. oAspiration can occur if the patient chokes n oral or gastric secretions. Thoracentesis The surgical perforation of the chest wall and pleural space with a large-bore needle. It is performed to obtain specimens for diagnostic evaluation, instill medication into the pleural space, and remove fluid (effusion) or air from the pleural space for therapeutic relief of pleural pressure. oDiagnoses:Heart Failure, Cirrhosis, Nephritic Syndrome, HypoproteinemiaEmpyemaExudates (inflammatory, infectious, neoplastic conditions)PneumoniaoAmount of fluid removed is limited to 1 Liter at a time to prevent re-expansion pulmonary edema. Mediastinal Shift
Shift of thoracic structures to one side of the bodyoMonitor vitals oAuscultate lungs for a decrease in or absence of breath soundsPneumothoraxA collapsed lung, can occur due to injury to the lung during the procedure.oMonitor for manifestationsoEducate on indications