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Ventiliation-Perfussion (VQ) scan
- ventilation- inhaled radioactive gas
- pefusion- radiologic contrast injected IV
- used to r/o PE
- CXR- PA, AP, lateral
- US
- CT scan
- MRI
-
Bronchoscopy
- remove deep lung secretions (snake like instrument)- obtain biopsies
- NPO 6 hours before
- nsg care after- close VS, monitor for resp distress, hemoptysis, NPO until gag reflex, check CXR results, inc swallowing could be bleeding
-
Pulmonary angiography
- constrast injected IV to examine pulmonary vasculature
- most of the dye is tracked by a series of xprays
- used to r/o PE- more invasive than VQ scan
- nsg same is cardiac cath
- - wacth site for bleeding, discomfort, VS, labs- lytes
-
Sputum collection
- before Abx (antibiotic) when possible (TB)
- brush teeth, clean mouth before
- first thing in the AM, esp AFB0 acid fast bacillus
- may need NTS- nose throat swab (with order) to obtain
- assess pre/post procedure
- note color, consistency, odor, amount
-
Thoracentesis
- drainage of fluid or air from pleural space
- therapeutic or diagnostic
- local anesthesia
- manual or vacuum drainage
-
Thoracentesis procedure- nursing
- before during
- before: position pt- upright, over table
- - if unstable, recumbent with arm over head
- - sedation PRN
- During:
- - monitor VS
- - observe for SOB, dyspnea, CP
- - assist the provider PRN
-
Thoracentesis procedure
- after
- position on unaffected side for 1 hour
- frequent VS- hemodynamic
- frequent breath sounds- escaped air
- report diminished breath sounds & tachyapnea- immediate***
- monitor for pneumothorax
- - CXR (if +, possibly chest tube insertion)
- record amount & color drainage
- assess for subcutaneous emphysema- crepitus - crackles
- maintain DSD, dry x 3D
- rate and depth will tell you about CO2
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