What is pleural effusion? - accumulation of fluid in the pleural space
What are some s/s of pleural effusion? - diminished lung sounds
decreased o2
increased RR
tachy
anxiety
friction rub
How is pleural effusion dx'ed? - x-ray
How is pleural effusion treated? - thoracentesis
What is thorac...
NUR 265 Exam 2 (Complete) What is pleural effusion? - accumulation of fluid in the pleural space What are some s/s of pleural effusion? - diminished lung sounds decreased o2 increased RR tachy anxiety friction rub How is pleural effusion dx'ed? - x-ray How is pleural effusion treated? - thoracentesis What is thoracentesis? - Insertion of a large bore needle through the chest wall into the pleural space to remove pleural fluid/air What position should the pt be in for a thoracentesis? - sitting up & leaning over can do at bedside What is done during the thoracentesis? - Poke between ribs can hook to syringe or vacuum sealed jar What if pt complains of pain during thoracentesis? - this is due to lung re -
expansion ask physician how much longer and that pt is feeling too much discomfort What to do 1st post op for thoracentesis? - 1st-assess lung sounds for possible pneumo when the lung re -expanded it could've hit the needle or lung could've collapsed What else to do post op for thoracentesis? - help pt to bed & put in high fowlers get chest xray What are the S/S of a pneumothorax? - SOB Tachy shallow resp asymetrical raise & fall of chest nagging cough cyanosis trachea slanted air hungry What is a bronchoscopy? - Insertion of a tube in the airways to view structures and obtain tissue samples What is a pulmonary embolism? - blood clot in the lungs What are risk factors for PEs? - DVT Immobility Estrogen Therapy Surg Obesity HF Stroke smoking What teaching should you do for PE? - Prevention is key lifestyle changes decrease weight stop smoking reposition car longer than 2hrs get out & walk What would PE benefit from? - interprofessional team What are PE s/s? - JVD SOB Chest pain Hypotension feeling of impending doom pleural friction rub petechiae What will PE ABGs be? - Resp alkalosis CO2 will be <35 pH will be >7.45 What is used to dx a PE? - abgs bnp d-dimer xray CT (best) What are nursing interventions for PE? - Monitor O2 Anticoagulants (heparin) Fibrinolytic therapy (TPA) Monitor q 1 -2hrs Will be sent home on warfarin Can PE pt be on heparin and warafin? - Yes they wean them off heparin but will start warfarin while on the heparin so they can go home on warfarin When patient is hyperventilating what is their ABGs? - resp alkalosis What is the antidote for heparin? - protamine sulfate What is the antidote for warfarin? - Vitamin K What can we do to get rid of the clot with a PE? - TPA will bust it up Embolectomy to remove it What is the tx for pt with PT with hypotension? - Give fluids If this does not help, can give dopamine With PE, blood will back up into the heart and into the body, symptoms will resemble? - R sided HF (ex. JVD) What is the PTT therapeutic range on Hep? - 37.5-87.5 What is the PT therapeutic range on warfarin? - 16.5-25 What is the INR therapeutic range on warfarin? - 1.2-3.0 What are s/s of ARF? - Hypoxemic hypoxia hypercapnia resp acidosis decreased loc
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