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Respiratory system

Nursing actions
Before the procedure
Explain the procedure to the client.
Withhold food and fluids for 6 to 12 hours,
if possible.
Make sure that written, informed consent
has been obtained.
Insert an I.V. catheter for fluid and medication administration.
During the procedure
Administer prescribed medications.
Monitor vital signs and cardiac rhythm.
After the procedure
Assess respiratory status.
Monitor vital signs and cardiac rhythm for
bradycardia, which may be caused by a vasovagal response.
Withhold food and fluids until the gag
reflex returns.
Check the cough and gag reflexes to
minimize the risk of aspiration. Monitor for
laryngeal edema.
Assess sputum.
If a biopsy was performed, monitor for
hemorrhage and pneumothorax.

Looking in from the outside

A chest X-ray produces a radiographic picture
of lung tissue. Its used to detect tumors, inflammation, air, and fluid in and around the lung. It
can also be used to monitor placement of such
equipment as catheters and chest tubes.
Clients who are
allergic to iodine
or seafood are at
risk for reactions in
any test involving
radiopaque dyes.

Nursing actions
Explain the procedure to the client.
Determine the clients ability to inhale and
hold his breath.
Make sure that the client removes jewelry
before the X-ray is taken.

Dye-ing to see the lungs

In pulmonary angiography, the client
receives an injection of a radiopaque dye
through a catheter. This provides a radiographic picture of pulmonary circulation.

Nursing actions
Before the procedure
Explain the procedure to the client.
Note the clients allergies to iodine, seafood, and radiopaque dyes.
Withhold food and fluids for 8 hours.

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Insert an I.V. catheter for fluid, medication,

and radiopaque dye administration.
Make sure that written, informed consent
has been obtained.
Instruct the client about possible flushing
of the face or burning in the throat after dye is
injected.
After the procedure
Monitor vital signs.
Assess peripheral neurovascular status.
Check the insertion site for bleeding.
Avoid taking blood pressure measurements in the extremity used for dye injection
for 24 hours after the procedure.

Sensitive about sputum

A sputum study is a laboratory test that
provides a microscopic evaluation of sputum,
evaluating it for culture and sensitivity, Gram
stain, and acid-fast bacillus.

Nursing actions
Explain the reason for the specimen and
how the specimen will be obtained.
Obtain an early-morning sterile specimen
from suctioning or expectoration.
Make sure that the specimen is truly
sputumnot salivabefore sending the
specimen to the laboratory.

Focusing on intrapleural fluid

In thoracentesis, a needle is used to obtain
a sample of intrapleural fluid to determine
the cause of infection or empyema. The client
undergoing thoracentesis receives local
anesthesia.

Nursing actions
Before the procedure
Explain the procedure to the client.
Make sure that written, informed consent
has been obtained.
Place the client in an upright position.
During the procedure
Monitor vital signs and cardiac rhythm.
Instruct the client not to cough or talk.
Monitor respiratory status and pulse
oximetry.
After the procedure
Assess the clients respiratory status;
assess breath sounds in all fields.
Monitor vital signs frequently.

4/8/2010 6:46:14 PM