Cheatography
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NONINVASIVE PROCEDURESPulse oximetry | Pulmonary function tests | Sputum culture | Computed tomography (CT) | MRI | Chest x-ray: use lead shield for adults of childbearing age |
ARTERIAL BLOOD GAS (ABGs)ABGs via arterial puncture or arterial line: Allows the most accurate method of assessing respiratory function | Perform Allen test if no arterial line | Sample is drawn into heparinized syringe | Keep on ice and transport to lab immediately | Document amount and method of oxygen delivered for accurate results | Apply direct pressure to puncture site at least 5 min | Monitor for hematoma |
BRONCHOSCOPYBronchoscopy: | Nursing Interventions: | Observe postprocedure: | Visualize larynx, trachea, bronchi | Maintain NPO 8 to 12 hr | Gag reflex | Obtain tissue biopsy | Provide local anesthetic throat spray | Bleeding | Foreign body removal | Obtain informed consent | Respiratory status | | | Position pt upright | Vital signs | | | Administer meds as prescribed (atropine - to reduce oral secretions, sedation, antianxiety | Level of consciousness | | | Label specimens |
| | MANTOUX TESTPositive test indicates exposure to TB | Diagnosis must be confirmed w/ sputum culture for presence of acid-fast bacillus (AFB) | Administer 0.1 mL purified protein derivative intradermal to upper half inner surface of forearm (insert needle bevel up) | Monitor for reaction in 48 to 72 hr following injection | Induration (hardening) of 10 mm or greater is considered a positive test | 5 mm can be considered significant if immunocompromised |
QuantiFERON-TB Gold test (QFT-FT) & T-SPOT.TBIdentify the presence of Mycobacterium tuberculosis infection by measuring the immune response to the TB bacteria in whole blood |
THORACENTESISThoracentesis: Surgical perforation of the pleural space to obtain specimen, to remove fluid or air, or to instill medication | Obtain informed consent | Reinforce pt education (remaining still, feeling of pressure, positioning) | Position the pt upright | Monitor respiratory status & vital signs | Label specimens | Document pt response, and amount, color, and viscosity of fluid | Maximum amount of fluid to be removed at one time is 1 L | Chest tube at bedside | Obtain CXR before & after procedure |
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