Week 5 Pre-Work
Test/Treatment What is it?
Pulmonary Function Assesses the lung function
Test and breathing problems.   bronchospasms after the study.  8 hrs before test.   by comparing them to
Measures lung VL
and capacity, flow rate
diffusions capacity, gas
exchange, airway
resistance, and distribution
of ventilation.  
Arterial Line A catheter inserted into a
artery that can
take continuous BP.   pulled.   holding continuous
Bronchoscopy Is the insertion if a tube in
the airways as far as the
secondary bronchi to
view airway structures and
obtain tissue samples.    s an altered iron state that does not
Thoracentesis Is a needle aspiration of
pleural fluid or air form the
plural space for diagnostic
or management purposes.
Name:
Complications to Monitor For Nursing Care Notes
Pt can have increase dyspnea and Inform the pt  not to smoke 6- Pts results are interpreted
Bronchodilator drugs may be expected findings for age,
held 4-6 hr before test.   gender, race, ht, wt, and
smoking status.  
Can have intensive bleeding.   Look at site for infections.  If line gets pulled make
Hold great pressure when it is sure that something is
pressure.  
If a benzo spray is used- it can Pt should be NPO 4-8 hrs before CBC, platelet count,
cause methemoglobinemia. A procedure to reduce the risk of prothrombin
conversion of normal hemoglobin aspiration.   time, electrolytes, and
to methemoglobin. Methemoglobin i Premedicate with a benzo.  chest X-ray test may be
Monitor pts pulse, BP, RR, and needed before
carry oxygen.   02.  procedure.  
Suspect this if the pt becomes Monitor until pts sedation has
cyanotic after topical anesthesia. Can subside and gage reflex have
be reversed with 02 and IV injection returned.  
of 1% methylene blue.   Keep monitoring VS every 15 min
for the first 2 hrs.  
Assess for bleeding, infection,
and hypoxemia.  
After the procedure a chest x-ray can Know if pt has any allergies.  Explain the pt is 
done to rule of Keep pt informed of what is going very important not to
possible pneumothorax and on in the produce.  move.  
mediastinal shift.   Assess for shock, pain, nausea, Pt will feel stinging local
pallor, diaphoresis, cyanosis, sensation from
tachypnea, and dyspnea.   anesthesia. 
Week 5 Pre-Work Name:
Listen to lungs to assess for Pt will feel pressure when
absent or reduced sounds on the the needle is pushed
affected side.  through the posterior
Check puncture site and dressing chest.  
for leaking or bleeding.  Instruct pt NOT to
Assess for reaccumulating of fluid deep breath to reduce the
in the pleural risk of puncturing the
space, subcutaneous emphysema pleura or lung.  
, infection,
tension pneumothorax.  
Teach pt the S/S
of pneumothorax (partial or
complete collapse of the lung) 
Week 5 Pre-Work Name:
Diagnosis What is it Treatment Monitor Nursing Actions Nursing Diagnosis (list Notes
2)
Pneumothora Air in the pleural space A chest tube therapy is Monitor breath Give IV fluids  Check for shifting of A biopsy will be
x causing a loss essential.    sounds on effected Give blood if the trachea.  done to see
of negative pressure in side.   prescribed    what caused
chest cavity. Leading to Check for Monitor blood Check chest tubing to the pneumotho
partial or total lung hyperresonance on loss  make sure it is rax. 
collapse.    percussion.  VS  draining.  
Patterns of  
breathing Chest X-ray, CT
scan,
or ultrasonogra
phy may be
used to
diagnose any
type of
pneumothorax

Tension Left threatening Immediate needle Monitor pt for Monitor blood Assess early to As a result,
Pneumothora complication of thoracostomy. A large- increased heart rate.  loss   prevent.  air collects
x pneumothorax in bore needle interested Check shifting VS    under pressure,
which air continues into the secondary of trachea to I&O  Check for shifting of completely coll
to enter the pleural intercostal space in the nonaffected side.   the trachea, draining apse the lung
space during inspiration midclavicular line of the Monitor of tubing, keep an eye and limits
and does not exit during affected side.   respiratory distress on VS (BP and HR blood return.
expiration.   A chest tube is than and cyanosis.  especially)  This leads to
placed in the fourth Distended neck vein  decreased
intercostal space Hemodynamic fulling of the
instability  heart and
reduced
cardiac output.
IF NOT caught
on time can be
fatal very
quickly.  
Week 5 Pre-Work Name:
Hemothorax Bleeding into the chest Chest tube placement and Listen for a dull sound Monitor chest Auscultate lungs frequ Hemothorax is
cavity.  to remove the blood in on percussion  tube closely.  ently.  blood loss less
Can be caused by blunt the pleural space to Provide   than 1000mL
chest trauma or normalize breathing and pulmonary Look for early signs- into the chest
complication of medical prevent infection. hygiene.  VS high, decreased cavity.  
procedure.  bleeding.  

Flail Chest A result of fractures of Usually treated with Monitor ABGs Assess Give psychosocial sup his causes
at least two neighboring positive pressure and vital capacity.  the pt for paradox port to the paradoxical
ribs in two or more ventilation.   VS  ical mov’t, anxious pt by chest wall
places    Fluid and electrolyte dyspnea, explaining movt (inward
For extreme cases- balance  cyanosis, procedures, talking mov’t of the
surgical stabilization of Monitor for tachycardia, and slowly, and allowing thorax during
required.   hypovolemia or hypotension.   time for expression of inspiration and
shock  feelings and outward movt
concerns.  during
expiration) 
Caused by
blunt force
trauma or
separation of
the ribs from
the cartilage. 

Pulmonary A common Treated with 02, and IV Monitor for dyspneic Make sure pt is At first chest
Contusion chest injury that occurs  fluids.  and hypotonic.   Provide oxygen as receiving sufficient 02 Xray be normal
most often with by A noninvasive positive Monitor for needed   and fluids.   but after
rapid pressure vent may be decreased breath Give IV fluids as   several
deceleration during car used for resp. distress sounds, crackles, whe prescribed.  Check for orders or days symptoms 
crashes pts.   ezing.  Place pt in a repeating chest X-ray and signs
A PEEP- positive Monitor for bruising, moderate- as it take some time can develop.
end- expiratory pressure v dry Fowlers to show up.  
ent may also be used to cough, tachycardia, positions.  
inflate the lungs. tachypnea. 
Monitor for dullness
Week 5 Pre-Work Name:
in percussion.  

Rib Fracture A blunt force trauma to Fractured ribs Monitor for adequate Manage pts pain Check for skin Splinting the
the ribs can fracture reunite spontaneously. gas exchange.   level.   breakdown chest reduces
them driving the bone under splints.  breathing
into the chest cavity.   Monitor 02 stats to depth
make sure enough and clearance o
prefusion is going on.   f secretions.  

Tracheobron Damage to the

chial Trauma airway structures involv
ing the trachea and
bronchi.  

Pulmonary A collection If pt is known to be at risk Monitor pts for Apply 02 by nasal Asses for DVT that can Common and
Embolism of particular matter for PE- small doses sudden onset of dysp cannula or mask.  lead to PE.  accounts for
(solids, liquids, or air) of heparin or low- nea.   Place pt in 100,000 death
that enters venous molecular wt heparin (eno S&S- tachypnea, high Fowlers posi in the US each
circulation and lodges in xaparin or levenox) can be crackles, pleural tion.   yr.  
the pulmonary vessels.  given.   friction rub, Assess resp.
Blood clot is the most tachycardia, diaphore status every 30
common.   sis.   min. 
Assess for neck
vein distention.