Diagnostic Tests
This diagnostic test measures lung volumes and capacities, diffusion capacity, gas exchange, flow rates, and airway resistance along with distribution of ventilation. What test is it?
Pulmonary function test
What are the differing Fi02 between Nasal Cannula, Simple Mask, Face Tent, and Non-rebreather Mask?
Nasal Cannula: 24-44%
Simple Mask: 40-60%
Face Tent: 24-100%
Non-rebreather Mask: 80-95%
What might a nurse find in an assessment of a patient with laryngeal cancer?
Hoarseness, cough, sore throat, pain and burning, especially with hot liquids and citrus juices, lump in the neck,, dysphagia, dyspnea, ulceration and foul breath
What would a nurse find in an assessment of a patient with lung cancer?
Cough or change in chronic cough, dyspnea, hemoptysis, chest or shoulder pain, recurring fever, repeated upper respiratory infections, and pleural effusion
What are the risk factors for a Pulmonary Embolus?
DVT, trauma (fracture of long bones), surgery, pregnancy, atrial fibrillation, heart failure, hypercoagulability, prolonged immobility
What is an Allen's test and when would it need to be performed?
Compression of the ulnar and radial arteries simultaneously while instructing the client to form a fist, then relaxing the hand while assessing the palm and fingers for blanching. Next the pressure is released from the ulnar artery while observing the hand for flushing caused by capillary refilling, hand should turn pink in 15 seconds. This test indicates patency of ulnar artery and ability to use radial artery to obtain ABGS.
What condition would the face tent be indicated in?
Facial trauma and burns
Management of laryngeal cancer is based upon _____ and _____.
Tumor staging and grading
TNM staging system --> tumor size, lymph nodes, and metastasis
Grading --> Stage 1 (localized), Stage 2-3 (N1-N2), Stage 4 (M1-M3)
Why does a pneumonectomy not require a chest tube?
You want the drainage to flow and solidify in the chest so that the remaining lung does not hyperinflate and shift the heart.
What might a patient with a pulmonary embolus present with?
dyspnea, air hunger, syncope, chest pain, sudden pleuritic, on inspiration; pressure in chest, anxiety, feelings of impending doom, chest wall tenderness
What is thoracentesis?
Surgical perforation of the chest wall and pleural space with a large-bore needle. It is performed to obtain specimens for diagnostic evaluation, to instill medication into the pleural space, and remove fluid or air from the pleural space for therapeutic relief of pleural pressure.
Which mode of oxygen therapy delivers the highest O2 concentration possible?
Non-rebreather mask
What are three nursing priorities for a patient who has undergone a partial or total laryngectomy?
Airway, Nutrition, and Speech
What is a pleural effusion?
A collection of fluid in the pleural space, usually secondary to other disease processes
Anticoagulation therapy --> Heparin and warfarin
What is the purpose of a pulmonary angiography?
Checks blood vessels of the lungs to see if they are occluded by a clot
the higher the concentration of oxygen that is given a patient the more it will dry mucous membranes which could cause them to crack and become infected.
What are the types of radiation therapy and what are their side effects?
External (Teletherapy) and Internal (Brachytherapy)
Side effects: Sin reaction, fatigue, xerostomia, loss of taste, mucositis
What are the signs and symptoms of pleural effusion?
S/s of underlying disease
Dyspnea or orthopnea
cough
decreased breath sounds, fremitus
dull, flat chest percussion
Decreased chest wall expansion
Tracheal deviation to unaffected side
What are the types of PE?
Blood clot, air, fat, amniotic fluid, septic
What are the pre and post procedure nursing responsibilities of Bronchoscopy?
Pre: assess for allergies to anesthetic agents or routine use of anticoagulants, consent form is signed, remove clients dentures, maintain NPO status 4-8 hr, administer medication
Post: monitor VS, assess LOC/gag reflex, provide oral hygiene, do not discharge until cough reflex and respiratory effort are present.
When suctioning it is important to remember to: apply suction during _______, apply suction _______, not longer than __________, and no more than __ passes, limit to _ minutes
withdrawal, intermittently, 10-15 seconds, 2, 5
What are the main risk factors for laryngeal cancer?
Tobacco, alcohol, genetics, age, vitamin deficiency, weak immune system
_________ can be used as both a diagnostic and management tool
Thoracentesis
What will be the trends of the vital signs with a PE?
Tachycardia, tachypnea, decrease O2 sat, fever, hypotension