-
ventilation- perfussion VQ scan
- ventilation- inhale radioactive gas
- perfusion- radiologic constrast injected IV
- used to r/o PE
- CXR- PA, AP and lateral
- US
- CT scan
- MRI
-
Bronchoscopy snake like instrument
- remove deep lung secretions, obtain biopsies
- NPO 6h before
- nsg care after: close VS, monitor resp distress, hemoptysis, NPO until return gag reflex, check CXR results
- swallowing may indicate bleeding
-
Pulmonary angiograpgy
- constrast injected IV to examine pulmonary vasculature
- movement of the dye is tracked by a series of xrays
- used to r/o PE more invasive than VQ scan
- Nsg- same as with cardiac cath
-
Sputum collection
- before antibiotic if possible
- brush teeth, clean mouth before
- first thing in the AM, esp AFB acid fasting bacillus
- may need NTS- nose throat swab (with order) to obtain
- assess pt pre/post procedure
- note color, consistency, odor, amoutn
-
thoracentesis
- drainage of fluid and air in pleural spaces
- therapeutic or diagnostic
- local anesthesia
- manual or vacuum drainage
-
thoracentesis
- before, during
- before- position pt- upright, over table
- - if unstable, recumbent with arm over head
- - sedation if needed
- during:
- - monitor VS
- - observe, SOB, dyspnea, chest pain
- - assist provider PRN
-
thoracentesis
- after
- position on unaffected sided for 1h
- frequent VS
- frequent breath sounds
- report diminished breath sounds, tachyapnea- immediatw
- monitor for pneumothorax
- - CXR- if +, possibly chest tube insertion
- record amount of drainage, color
- assess for subcuteneous, emphysema- crepitus
- maintain DSD, dry x 3d
- rate and depth will tell you about Co2
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