Diagnostic Procedures- Complex Oxygenation

Question 1

What is bronchoscopy?

Answer 1

Insertion of a tube in the airways as far as the secondary bronchi to view airway structures and obtain tissue samples.

Used to diagnose and manage pulmonary diseases.

Question 2

What should be done to prepare a patient for bronchoscopy?

Answer 2

Explain the procedure, verify consent, discuss expected outcomes, risks, and benefits, document allergies, and order necessary tests.

Tests may include complete blood count, platelet count, prothrombin time, electrolytes, and chest x-ray.

Question 3

What is the NPO requirement before a bronchoscopy?

Answer 3

The patient is NPO for 4 to 8 hours before the procedure.

This is to reduce the risk for aspiration.

Question 4

What types of medications may be administered before a bronchoscopy?

Answer 4

Benzodiazepines for sedation and amnesia; opioids may also be used.

Premedication is aimed at providing comfort during the procedure.

Question 5

What should be monitored during follow-up care after a bronchoscopy?

Answer 5

Monitor until sedation effects have resolved and gag reflex has returned; check vital signs and breath sounds every 15 minutes for the first 2 hours.

Vital signs include oxygen saturation.

Question 6

What potential complications should be assessed for after bronchoscopy?

Answer 6

Bleeding, infection, or hypoxemia.

Question 7

True or False: The primary health care provider must discuss the risks and benefits of bronchoscopy with the patient.

Answer 7

True.

Question 8

Fill in the blank: Bronchoscopy is used to obtain _______ samples.

Answer 8

tissue

Question 9

What is thoracentesis?

Answer 9

The needle aspiration of pleural fluid or air from the pleural space for diagnostic or management purposes.

Question 10

What is the purpose of microscopic examination of pleural fluid?

Answer 10

Helps in making a diagnosis.

Question 11

Why may pleural fluid be drained?

Answer 11

To relieve blood vessel or lung compression and respiratory distress caused by cancer, empyema, pleurisy, or tuberculosis.

Question 12

What can be instilled into the pleural space during thoracentesis?

Answer 12

Drugs.

Question 13

What is essential before performing thoracentesis?

Answer 13

Patient preparation.

Question 14

What should a patient expect during thoracentesis?

Answer 14

A stinging sensation from the local anesthetic and a feeling of pressure when the needle is pushed through the posterior chest.

Question 15

What should patients avoid during thoracentesis?

Answer 15

Moving, coughing, or deep breathing.

Question 16

What must be verified before thoracentesis?

Answer 16

That the patient has signed an informed consent.

Question 17

What might be done to the hair on the skin over the aspiration site?

Answer 17

Clipped if necessary.

Question 18

What is important regarding patient positioning during thoracentesis?

Answer 18

Properly position and physically support the patient.

Question 19

What is the purpose of a chest x-ray after thoracentesis?

Answer 19

To rule out possible pneumothorax and mediastinal shift.

Question 20

What should be monitored after thoracentesis?

Answer 20

Vital signs and lung sounds.

Question 21

What complications should be assessed for after thoracentesis?

Answer 21

Reaccumulation of fluid, subcutaneous emphysema, infection, and tension pneumothorax.

Question 22

What should patients be urged to do after thoracentesis?

Answer 22

Breathe deeply to promote lung expansion.

Question 23

What should be documented after thoracentesis?

Answer 23

The patient’s response, volume and character of fluid removed, specimens sent to the laboratory, location of puncture site, and respiratory assessment findings.

Question 24

What is subcutaneous emphysema?

Answer 24

The presence of air in the tissue layers of the skin, seen as skin swelling around the puncture site.

Question 25

What sound is produced when pressure is applied to areas with subcutaneous emphysema?

Answer 25

A crackling sound.

Question 26

What could persistent subcutaneous emphysema indicate?

Answer 26

A persistent air leak caused by a puncture that tears the pleura.

Question 27

What symptoms should patients be taught to recognize for pneumothorax?

Answer 27

Pain on the affected side, rapid heart rate, rapid shallow respirations, feeling of air hunger, prominence of the affected side, trachea slanted to the unaffected side, new onset of nagging cough, cyanosis.

Question 28

Fill in the blank: Thoracentesis is performed to relieve _______ or _______ distress.

Answer 28

[blood vessel] or [lung] distress.

Question 29

True or False: Local anesthetic can cause discomfort during thoracentesis.

Answer 29

True.

Question 30

What is the purpose of a lung biopsy?

Answer 30

To obtain tissue for histologic analysis, culture, or cytologic examination. ## Footnote Samples are used to make a definitive diagnosis of inflammation, cancer, infection, or lung disease.

Question 31

What might a patient associate the term 'biopsy' with?

Answer 31

Cancer. ## Footnote Patients may worry about the outcome of the biopsy.

Question 32

What should be explained to the patient before a lung biopsy?

Answer 32

What to expect before and after the procedure, and explore the patient’s feelings. ## Footnote This helps alleviate patient anxiety.

Question 33

What type of medication may be ordered before the procedure?

Answer 33

An analgesic or sedative. ## Footnote This is to help the patient feel more comfortable.

Question 34

What reduces discomfort during a percutaneous lung biopsy?

Answer 34

A local anesthetic agent. ## Footnote Pressure may still be felt during needle insertion and tissue aspiration.

Question 35

In what setting is an open lung biopsy performed?

Answer 35

In the operating room under general anesthesia. ## Footnote The usual preparations before surgery apply.

Question 36

How often should a patient's vital signs and breath sounds be monitored after a lung biopsy?

Answer 36

At least every 4 hours for 24 hours. ## Footnote This is critical for patient safety.

Question 37

What signs should be assessed for in the patient after the procedure?

Answer 37

Signs of respiratory distress such as dyspnea, pallor/ash gray skin, diaphoresis, tachypnea. ## Footnote These signs indicate potential complications.

Question 38

What is a serious complication of needle biopsy and open-lung biopsy?

Answer 38

Pneumothorax. ## Footnote It is essential to monitor for this complication.

Question 39

What should be reported immediately during follow-up care?

Answer 39

Reduced or absent breath sounds. ## Footnote This may indicate a serious issue.

Question 40

What should be monitored for that may occur after a lung biopsy?

Answer 40

Hemoptysis or frank bleeding from vascular or lung trauma. ## Footnote Hemoptysis may be scant and transient.

Question 41

S/S of pneumothorax

Answer 41

Absent or decreased lung sounds Asymmetric rise and fall w/ respiration Pain Tachypnea SubQ emphysema Increased HR and RR Decreased O2 ## footnote UNEXPECTED s/s after Thoracentesis