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Dx Studies of Resp. SystemMedical Surgical Nursing

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What test is used for inspection and biopsy of lymph nodes in the mediastinal area?
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Mediastinoscopy
T/F A mediastinoscopy doesn't require signed permission.
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False, it is a surgical procedure which requires informed consent
What procedures can be used to obtain a lung biopsy?
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Transbronchial, percutaneous, or transthoracic needle aspiration (TTNA), video assisted thoracic surgery (VATS), or open lung biopsy.
A patient has had a transthoracic needle aspiration (TTNA). What things should you monitor for?
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Monitor breath sounds every four hours for 24 hours and report any distress. Check the incision site for bleeding, and a Chest Xray should be done to check for pneumothorax.
With VATS, a ________ may be kept in post-procedure until the lung has reexpanded. The nurse should monitor for breath sounds to follow chest expansion and encourage deep breathing to help the lung reinflate.
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Chest tube
A ________ is used to obtain a specimen of the pleural fluid for diagnosis, to remove pleural fluid, or to instill medication.
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Thoracentesis
After a thoracentesis, a __________ is always obtained to check for complications.
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A chest xray (to check for pneumothorax)
T/F A thoracentesis is normally performed in the OR.
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False, it is usually performed in the patient's room.
How should a patient be positioned for a thoracentesis?
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They should be upright, with their elbows on the overbed table and their feet supported.
What should a nurse monitor for during and after a thoracentesis?
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Hypoxia and pneumothorax, and listen to breath sounds in all lung fields after the procedure. Encourage deep breathing.
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T/F A patient should be encouraged to cough and deep breathe during a thoracentesis to ensure that a pneumothorax doesn't develop.
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False, the patient should not cough or talk during a thoracentesis. They should be encouraged to deep breathe only after it is done.
When scheduling a pulmonary function test (PFT), a nurse should avoid scheduling it immediately after…
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Mealtimes
A patient that is getting a pulmonary function test should have their last dose of a bronchodilator at least ______ hours, prior to the test.
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6 hours
Laser therapy, electrocautery, cryotherapy and stents can be placed through a ____________ to achieve patency of an airway that has been partially or completely obstructed by a tumor.
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bronchoscope
This is a procedure performed during a bronchoscopy that involves injection of approximately 30 mL of saline which is then withdrawn to observe cells that have been captured. This helps diagnose pneumocystitis pneumonia among other conditions.
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Bronchoalveolar lavage (BAL)
Where is the incision made for a mediastinoscopy?
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In the suprasternal notch
A combination of _________ and _________ is used to differentiate lung infection and rejection in lung transplant recipients.
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Transbronchial lung biopsy and BAL
A transbronchial lung biopsy is performed with a ____________. A percutaneous needle aspiration or TTNA involves inserting a needle through the _________ under CT guidance.
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Transbronchiol lung biopsy: bronchoscopy Percutaneous needle aspiration and TTNA: incision in the chest wall
In _______, a rigid scope with a lens is passed through a trocar placed into the pleura via one or two small incisions in the intercostal muscles.
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VATS
Lesions in the pleura or peripheral lung are usually biopsied via the ________ procedure.
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VATS
__________ biopsies are done when other procedures are unsuccessful at obtaining a diagnosis.
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Open lung biopsies
  
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