Nursing Procedures and Complications Quiz
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Questions and Answers

What immediate action should be taken if a client exhibits signs of air embolism during catheter insertion?

  • Position the client on their left side in Trendelenburg position (correct)
  • Place the client on their right side
  • Perform a chest x-ray immediately
  • Administer intravenous fluids

    • What is the primary nursing responsibility immediately following a thoracentesis?

  • Administer medication for pain control
  • Initiate chest physiotherapy
  • Apply a dressing over the puncture site and assess for bleeding (correct)
  • Schedule a follow-up appointment with a specialist

    • Which complication is specifically characterized by a shift of thoracic structures to one side of the body?

  • Pleural effusion
  • Pneumothorax
  • Hemothorax
  • Mediastinal shift (correct)

    • Which symptom is NOT associated with a potential air embolism?

    <p>Increased blood pressure</p> Signup and view all the answers

    What should the nurse monitor for signs of pneumothorax after a thoracentesis?

    <p>Diminished breath sounds</p> Signup and view all the answers

    What is an indication for performing a bronchoscopy?

    <p>Visualization of abnormalities like tumors</p> Signup and view all the answers

    Why is a chest tube inserted into the pleural space?

    <p>To drain fluid, blood, or air and establish negative pressure</p> Signup and view all the answers

    What should be assessed prior to performing a bronchoscopy?

    <p>Allergies to anesthetic agents</p> Signup and view all the answers

    What is the purpose of the second chamber in a disposable three-chamber drainage system for chest tubes?

    <p>Creation of a water seal</p> Signup and view all the answers

    What is the primary reason for maintaining NPO status before a bronchoscopy?

    <p>To reduce the risk of aspiration</p> Signup and view all the answers

    What complication may arise specifically during a bronchoscopy with a biopsy?

    <p>Perforation or bleeding</p> Signup and view all the answers

    Which condition is NOT typically an indication for chest tube insertion?

    <p>Hypertension</p> Signup and view all the answers

    Which patient's condition suggests the need for bronchoscopy for therapeutic reasons?

    <p>Patient with pneumonia and heavy sputum</p> Signup and view all the answers

    What action should the nurse prioritize during the preprocedure phase of chest tube insertion?

    <p>Verify that the consent form is signed</p> Signup and view all the answers

    What should the nurse do if symptoms of an air embolism occur in a client?

    <p>Administer oxygen therapy and notify the provider</p> Signup and view all the answers

    Which of the following is a sign of potential complications following chest tube insertion?

    <p>Diminished breath sounds on the affected side</p> Signup and view all the answers

    What is the primary reason for administering humidification during oxygen therapy?

    <p>To reduce the risk of laryngeal edema</p> Signup and view all the answers

    What is a common complication of a rigid bronchoscopy?

    <p>Pneumothorax</p> Signup and view all the answers

    Which position should the client be in during a thoracentesis?

    <p>Sitting upright with arms supported</p> Signup and view all the answers

    What key action should a nurse take to prevent aspiration during care?

    <p>Withhold oral fluids until the gag reflex returns</p> Signup and view all the answers

    Which of the following indicates a potential diagnosis for performing thoracentesis?

    <p>Empyema</p> Signup and view all the answers

    What is a pre-procedure responsibility for a nurse before thoracentesis?

    <p>Ensure the client has signed the informed consent form</p> Signup and view all the answers

    What should be monitored throughout the thoracentesis procedure?

    <p>The client’s vital signs and oxygen saturation</p> Signup and view all the answers

    Why is ultrasound used during thoracentesis?

    <p>To improve visibility and decrease the risk of complications</p> Signup and view all the answers

    What does an arterial blood gas (ABG) measure?

    <p>Partial pressure of carbon dioxide and oxygen</p> Signup and view all the answers

    Which test should be performed to verify circulation before an arterial puncture?

    <p>Allen’s test</p> Signup and view all the answers

    Which of the following describes a complication that may arise from an arterial puncture?

    <p>Hematoma</p> Signup and view all the answers

    What is indicated if loss of pulse is observed at the ABG sampling site?

    <p>Potential arterial occlusion</p> Signup and view all the answers

    What should be done immediately after performing an arterial puncture?

    <p>Hold direct pressure over the site</p> Signup and view all the answers

    In monitoring ABG results, what can help evaluate a client's response to weaning from mechanical ventilation?

    <p>PaCO2 and pH levels</p> Signup and view all the answers

    Which client condition may affect blood pH levels?

    <p>Respiratory disease</p> Signup and view all the answers

    What does the SaO2 measurement indicate?

    <p>Percentage of oxygen-bound hemoglobin</p> Signup and view all the answers

    What is a potential complication of thoracentesis that involves a shift of the mediastinum?

    <p>Mediastinal Shift</p> Signup and view all the answers

    Which sign indicates a possible tension pneumothorax following thoracentesis?

    <p>Tracheal deviation</p> Signup and view all the answers

    Which of the following is an appropriate nursing action to prevent infection during thoracentesis?

    <p>Maintain sterile technique</p> Signup and view all the answers

    What finding may indicate bleeding post-thoracentesis that requires monitoring?

    <p>Hypotension</p> Signup and view all the answers

    What is a common symptom of pneumothorax that a nurse should monitor after thoracentesis?

    <p>Nagging cough</p> Signup and view all the answers

    What is the primary purpose of pulmonary function tests (PFTs)?

    <p>To determine lung function and breathing difficulties</p> Signup and view all the answers

    Which of the following is NOT a measure assessed during pulmonary function tests?

    <p>Kidney filtration rate</p> Signup and view all the answers

    What is the recommended action for a smoker prior to undergoing PFTs?

    <p>Avoid smoking for 6 to 8 hours before testing</p> Signup and view all the answers

    Which condition is classified as obstructive disease in PFT results?

    <p>Asthma</p> Signup and view all the answers

    For what primary reason might a patient undergo pulmonary function tests before surgery?

    <p>To determine fitness for surgery</p> Signup and view all the answers

    What are arterial blood gases (ABGs) primarily used to evaluate?

    <p>Respiratory status and acid-base balance</p> Signup and view all the answers

    Which of the following is an example of restrictive lung disease?

    <p>Obesity</p> Signup and view all the answers

    What is the main indication for pulmonary function testing?

    <p>Assessing response to medication in respiratory diseases</p> Signup and view all the answers

    Study Notes

    Nursing Care of Clients with Respiratory Disorders

    • This presentation covers nursing care for clients with respiratory disorders.
    • It reviews anatomy and physiology related to the respiratory system.
    • It also examines diagnostic procedures for evaluating respiratory status.

    Review of Anatomy and Physiology

    • The respiratory system involves the nasal cavity, mouth, pharynx, larynx, trachea, bronchi, and lungs.
    • The lungs contain alveoli where gas exchange occurs.
    • Oxygen is taken in and carbon dioxide is released.
    • The diaphragm and intercostal muscles are involved in breathing.
    • The pulmonary artery carries blood to the lungs and the pulmonary vein carries blood from the lungs to the heart.

    Review of Anatomy and Physiology (Continued)

    • The diagrams show the different parts of the respiratory system and the process of gas exchange in the alveoli.
    • The diagrams illustrate the flow of air from the nose and mouth into the lungs via the trachea, bronchi, and bronchioles to the alveoli.

    Review of Anatomy and Physiology (Continued)

    • Diagrams illustrate the structures and their roles, emphasizing the flow.
    • Diagrams show the upper and lower respiratory tracts and their components.

    Review of Anatomy and Physiology (Continued)

    • Diagrams show the lobes of the lungs, and the position of lymph nodes.

    Alveolus Gas Exchange

    • The alveoli are small air sacs in the lungs where gas exchange occurs.
    • Oxygen diffuses into the blood, and carbon dioxide diffuses out of the blood.

    Respiratory Diagnostic Procedures

    • Diagnostic procedures evaluate a client's respiratory function.
    • This includes oxygenation of the blood, lung function, and the integrity of the airway.
    • The key procedures include Pulmonary Function Tests (PFTs), ABGs, Bronchoscopy, and Thoracentesis.

    Pulmonary Function Test (PFT)

    • PFTs measure lung volumes and capacities.
    • It assesses diffusion capacity and gas exchange, flow rates, and airway resistance
    • Identification of lung disease, helpful for clients with shortness of breath.
    • Performed pre-surgical to evaluate respiratory risk.
    • Clients who smoke need to abstain x hours before testing.
    • Inhalers should be stopped for a specific time period before testing.

    Pulmonary Function Test (PFT) (Continued)

    • Indicated for clients with shortness of breath or to evaluate disease severity and treatment response
    • It can also be used to determine suitability for surgery (e.g., thoracic surgery/lung resection).
    • Includes measures like spirometry, lung volumes, diffusion capacity, gas exchange, and other lung function tests including airway responsiveness, respiratory muscle testing, and lung compliance

    Arterial Blood Gas (ABG)

    • ABGs measure the amount of free hydrogen ions (pH), partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), bicarbonate concentration (HCO3), and the percentage of oxygen bound to hemoglobin (SaO2).
    • ABG testing assesses oxygenation and acid-base balance.
    • Possible causes of blood pH imbalance include respiratory, renal, malnutrition, electrolyte imbalances, endocrine, or neurological issues
    • Helpful for monitoring treatment effectiveness, guiding oxygen therapy, and evaluating client response to weaning.

    Arterial Blood Gas (ABG) (Continued)

    • Pre-procedure: Allen's test verifies radial and ulnar circulation before arterial puncture.
    • Post-procedure: Hold direct pressure over the puncture site and monitor for complications like bleeding, loss of pulse, swelling, discoloration, and changes in temperature.
    • Report results promptly to the healthcare provider.
    • Potential complications include hematoma.
    • Potential complications include air embolism.

    Bronchoscopy

    • Bronchoscopy allows visualization of the larynx, trachea, and bronchi.
    • It's performed as outpatient procedure under general anesthesia, or locally. • Bronchoscopy can be used for diagnosis (biopsy of suspected tumors/cancer). • Can be used to remove foreign objects from the airway.
    • It may be used for treating conditions like pneumonia or postoperative atelectasis.

    Bronchoscopy (Continued)

    • Pre-procedure: Evaluate for anesthetic agent allergies and anticoagulant use, ensure informed consent is signed, remove dentures.
    • Intra-procedure: Position the patient; administer sedatives/anxiolytics or atropine, monitor, collect and label tissue samples.
    • Post-procedure: Monitor level of consciousness, gag reflex, and ability to swallow before allowing oral intake, monitor for complications.
    • Post-procedure: Monitor for complications like fever, cough, hemoptysis, and laryngospasm.

    Bronchoscopy complications

    • Potential complications include laryngospasm.
    • Potential complications include pneumothorax.
    • Potential complications include aspiration.

    Thoracentesis

    • Thoracentesis is the surgical perforation of the chest wall and pleural space with a large-bore needle
    • Performed to remove pleural fluid or air for diagnostic evaluation.
    • Performed under local anesthesia at bedside/procedure room
    • Use of ultrasound guidance minimizes complications
    • Position patient upright, with arms and shoulders supported to minimize risk during the procedure.

    Thoracentesis (Continued)

    • Pre-procedure: Ensure informed consent; obtain pre-procedure X-ray; gather supplies.
    • Intra-procedure: Assist the provider with the procedure; monitor patient vital signs; monitor for complications.
    • Post-procedure: Apply a dressing; monitor vital signs and respiratory status; provide oral hygiene; encourage deep breathing; obtain a post-procedure CXR to evaluate for complications; monitor for complications like pneumothorax, bleeding, or infection.

    Thoracentesis Complications

    • Complications include: Mediastinal shift
    • Complications include: Pneumothorax
    • Complications include: Bleeding
    • Complications include: Infection

    Chest Tube Insertion and Monitoring

    • Chest tubes drain fluid or air from the pleural space, reestablishing negative pressure and facilitating lung expansion
    • Chest tubes can be inserted in the emergency department, operating room, or bedside.
    • Chest tubes are removed when lung expansion is complete and drainage ends.

    Chest Tube Systems

    • Drainage systems usually consist of three parts: The drainage collection chamber, the water-seal chamber, and the suction control chamber.
    • The water-seal chamber prevents air from re-entering the pleural space.

    Chest Tube Insertion Nursing Responsibilities

    • Pre-procedure: Verify consent, reinforce client teaching (breathing, allergies), position client, prepare equipment.
    • Intra-procedure: Set up the drainage system, assist the healthcare provider with the insertion, monitor patient, position the chest tube.
    • Post-procedure: Monitor vital signs hourly, respiratory status; encourage deep breathing; evaluate and record the client's response.

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    Related Documents

    Nursing Care of Clients with Respiratory Disorders PDF

    Description

    Test your knowledge on critical nursing procedures such as thoracentesis and bronchoscopy. This quiz covers immediate actions for complications, assessments, and indications for various nursing interventions. Get ready to evaluate your understanding of these essential topics in nursing care.

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