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71 Cards in this Set
- Front
- Back
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Purpose of PULMONARY FXN TEST (3)
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1. detect impared pulm fxn
2. follows the course of pulm dz 3. eval tx re |
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What should you withhold prior to a pulmonary fxn test?
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1. no smoking 4 hr before test
2. withhold bronchodilator meds |
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How does pulm fxn test work?
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ask to breathe into a machine
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What should you observe for after a pulmonary fxn test?
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dyspnea
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What do ABGs measure? (4)
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1. tissue oxygenation
2. CO2 removal 3. acid-base balance 4. evaluates pt being mechanically ventilated or w/ CVD |
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Which check should you do prior to doing an ABG?
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Allen test
(check for collateral circulation) |
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What type of syringe should be used to obtain blood for an ABG?
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heparinized syringe
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What type of blood must be provided to the lab to perform an accurate ABG?
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1. unclotted blood is necessary
2. NO air bubbles in specimen |
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s/p an ABG, what should the nurse do to the site? why?
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apply P to site for 5 min to prevent hematoma
(15 min if pt is receiving anticoagulants) |
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How should you send a specimen that you've taken for an ABG?
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on ice.
occlude the needle to avoid air in the syringe |
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What info should you note on the lab slip when sending a specimen for an ABG?
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note if pt was breathing room air or oxygen (document L)
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What should you assess in the pt s/p an ABG blood draw? (5)
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1. arm swelling
2. discoloration 3. pain 4. numbness 5. tingling |
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Purpose of a LUNG SCAN (V/Q SCAN)?
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to evaluate pulmonary perfusion when pulmonary infarction or space-occupying disorders are suspected
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What 2 scans comprise the lung scan?
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1. perfusion scan
2. ventilation scan |
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What comprises the perfusion scan?
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IV injection of iodinated radioactive dye
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What comprises the ventilation scan?
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radioactive gas inhaled
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What should you analyze in a perfusion scan?
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high levels of radioactivity in areas of good perfusion
low levels of radioactivity in obstructed areas |
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What should you analyze in a ventilation scan?
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there should be an equal dist of gas
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Why would one do a SPUTUM ANALYSIS? (2)
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1. ID cause of pulmonary infection
2. ID abnormal lung cells |
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What should a pt do prior to a sputum analysis? (3)
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1. encourage fluid intake night before
2. rinse mouth w/ water 3. do NOT brush teeth, eat, or use mouthwash before test |
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What should you give prior to sputum analysis? why?
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ultrasonic/heated nebulizer tx 10-15 min prior to a sputum analysis aids in collection
*TEACH pt how to expectorate |
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What type of container should you use for a sputum analysis?
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STERILE
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When should you ideally collect the sputum analysis sample?
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early in the AM if possible
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A bronchoscopy allows for visualization of ___(3)?
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1. larynx
2. trachea 3. mainstem bronchi |
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What are possible purposes of doing a bronchospy? aside from visualization (5)
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1. obtain tissue biopsy
2. apply meds 3. aspirate secretions for lab exam 4. aspirate mucus plug causing airway obstruction 5. remove aspirated foreign objects |
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How long must one be NPO prior to a bronchoscopy?
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6 hr prior
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What should you inspect in the mouth prior to a bronchoscopy?
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inspect for infection
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Which pre-meds can you admin prior to a bronchoscopy?
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1. Valium
2. Versed 3. Demerol 4. Atropine |
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Can you keep dentures in for a bronchoscopy?
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NO
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What should a client expect s/p a bronchoscopy?
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a sore throat
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What position should a pt be in s/p bronchoscopy?
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sit or lie on side
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How long must a pt remain NPO s/p a bronchoscopy?
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until gag reflex returns
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What should you observe for s/p a bronchoscopy?
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respiratory difficulties
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What is a thoracentesis?
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aspiration of fluid or air from pleural space
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Why might one do a thoracentesis? (4)
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1. obtain specimen for analysis
2. relieve lung compression 3. obtain lung tissue for bx 4. meds into pleural space |
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What post-op actions must a nurse do prior to a pt's thoracentesis?
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1. explain procedure
2. take VS 3. shave area around needle insertion site 4. expect stinging sensation of local anesthetic and feeling pressure when needle is inserted |
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What position should a pt be in for a thoracentesis?
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sitting w/ arms on pillow s on over-bed table
or lying on side in bed |
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How much fluid can be withdrawn in a thoracentesis at one time?
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no more than 1 L
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After a thoracentesis, what should a nurse do? (4)
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1. aus breath sounds freq
2. VS freq 3. check for leakage of fluid, locn of puncture site, and pt tolerance 4. sterile dressing s/p procedure |
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Why might one do a CXR?
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to ID abnormalities:
foreign bodies, fluid, infiltrates, tumors |
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What should a female of child-bearing age wear during a CXR?
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a lead apron
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What should you remove prior to a CXR?
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all jewelry from neck and chest
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Why do a lung bx?
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removal of lung tissue for CULTURE or CYTOLOGY
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Which meds do you give a pt prior to a lung bx?
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1. sedatives
2. analgesics |
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When should a pt hold breath during a lung bx?
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MID-EXPIRATION
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What type of monitoring assists the surgeon doing the lung bx?
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fluoroscopic monitoring
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How should a pt be positioned for a lung bx?
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1. sitting w/ arms on pillows on side-table
or 2. side lying in bed *same as thoracentesis |
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How often should the nurse monitor breath sounds and VS s/p a lung bx?
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q4 hr for 24 hr
*report signs of respiratory distress |
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What procedure should be done AFTER a lung bx? why?
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CXR: to check for complication s/p pneumothorax
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Will there be a dressing after a lung bx?
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yes, a sterile one
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What is a CT (computed tomography)
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Provides a 3D assessment of the LUNGS AND THORAX
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Is a CT an invasive procedure?
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no
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What post-CT action should be considered
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assess for rxn if a dye was used
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What is an MRI?
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provides detailed pics of body structures
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What should you assess pt for prior to MRI?
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1. claustrophobia
2. ask if pt has metal implanted in body (pacemaker, clips) 3. remove all metal jewelry and metal objects |
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What does an ANGIOGRAPHY do?
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evaluates specific areas of the arterial system
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s/p an angiography, what should you assess for? (4)
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1. hematoma
2. distal pulses 3. skin T, color, sensation (compared in both extremities) 4. VS freq *notify MD if bleeding or change in VS occurs |
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What does a pulse-ox measure?
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the o2 saturation (through the skin)
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How do you prepare the placement of a pulse-ox?
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-clean site w/ a cotton ball, soap, water and then alcohol
-dry the skin |
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How often should you rotate a pulse-ox site? why?
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q4h to prevent skin breakdown
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Purpose of a stress test?
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to assess cardiovascular response to an increased workload
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What does a stress test consist of?
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pt walks on a treadmill, pedals a bike, or climbs stairs
EKG before, during, and after exercise testing |
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What is an ultrasound echocardiogram?
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noninvasive sound waves used to determine cardiac structures
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What is a cardiac cath?
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introduction of a cath into chambers of the heart
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What does a cardiac cath evaluate?
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VENTRICULAR fxn and to obtain chamber pressures
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What test is often used in conjunction w/ a cardiac cath?
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angiography
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What should a pt do prior to a cardiac cth? (3)
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1. NPO 8-12 hr prior
2. signed permit 3. empty bladder |
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What should a nurse do prior to a pts cardiac cath?
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1. check PULSES
2. explain that pt might experience: -heat -palpitations -desire to cough during dye injection**** |
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How often should you monitor VS s/p cardiac cath?
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q15 min for 2 hr
q30 min for 1 hr q1 hr for 3 hr |
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How often should you check pulses, sensation, and bleeding at insertion site s/p cardiac cath?
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q 30 min for 3 hr
q 1 hr for 3 hr |
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special precaution for a pt s/p a cardiac cath?
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BEDREST 6-8 hr w/ INSERTION SITE EXTREMITY STRAIGHT
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