System
Rachel S. Natividad, RN, MSN, NP
N212 Medical Surgical Nursing 1
Gas exchange
functional alveoli
in Pa02
Diagnostics
Pulse Oximetry
Chest X-Ray
Computed Tomography
(CT scan)
Bronchoscopy
Thoracentesis
Pulmonary Function
Tests
False readings
Intermittent or continuous
monitoring
When to Notify MD
< 91%
86% (Medical Emergency)
Screen, diagnose,
evaluate treatment
Instructions: No
metals/jewelry
Infiltrates
Diagnostics: Computed
Tomography: CT Scan
Uses contrast
agents
Instructions:
Diagnostics: Bronchoscopy
Procedure Care/Instructions:
NPO 6 -8 hrs prior
Sedation during procedure
Post Procedure:
HOB elevated
Observe for hemorrhage
NPO until gag reflex returns
Diagnostics: Pulmonary
Function Test (PFTs)
Instructions:
No bronchodilators 6
hours prior
Diagnostics: Thoracentesis
Specimen from
pleural fluid
Treat pleural
effusion
Assess for
complications
Post-Procedure care:
CXR after procedure
Positions
Sitting on side of bed over bedside table
chest
elevated
Lying on affected side
Straddling a chair
Assessment: Cues to
Respiratory Problems
Dyspnea
Cough
Sputum
Pneumonia: Etiology
Cause
bacteria (75%)
viruses
fungi
Mycoplasma
Parasites
chemicals
Pneumonia: Classifications
Hospital-acquired Pneumonia(HAP/nosocomial)
Aspiration pneumonia
Pneumocystis Carinii
CAP
Older adult
Chronic/coexisting
condition
Recent history or
exposure to viral or
influenza infections
History of tobacco or
alcohol use
HAP
Older adult
Chronic lung disease
ALOC
Aspiration
ET, Trach, NG / GT
Immunocompromised
Mechanical ventilation
Pneumonia: Clinical
Manifestations
Pneumonia: Clinical
Manifestations-Cont.
Mycoplasma (Atypical)
feeling tired or weak,
headaches, sore throat,
or diarrhea.
walking pneumonia
Pneumonia: Diagnosis
Diagnosis
Physical exam
crackles,
rhonchi/wheezes
Sputum specimen
Gram stain
LUL Infiltrates
Pneumonia :Interventions/Tx
Treatment
Antibiotics choose based on age,
suspected cause & immune status
Nursing Diagnoses
Pneumonia: Complications
Hypoxemia
Pleural effusion
Atelectasis
Pleurisy
Atelectasis
Pleurisy
Pleural Effusion
Any Questions?