Mastering Respiratory Nursing: A Comprehensive Practice Guide
This article serves as a comprehensive guide to respiratory nursing, offering insights into diagnostic tests, expected lab values, and essential nursing interventions. It aims to equip nurses and nursing students with the knowledge and skills necessary to provide optimal care for patients with respiratory conditions. This guide provides NCLEX practice questions to help you prepare for the NCLEX exam. These quizzes are designed to test your knowledge on what you may encounter on the NCLEX exam.
Understanding Respiratory Diagnostic Tests and Lab Values
As part of your Med-Surg education, it's important to learn about the diagnostic tests and expected labs for each body system that you are studying. When you learn about diseases and disorders of the respiratory system, you will learn about the diagnostics, including when lab values are out of the normal range. Understanding the diagnostic tests and expected lab values for the respiratory system is crucial for nurses. This section provides a detailed overview of key assessments and their clinical significance.
Arterial Blood Gases (ABGs)
An arterial blood gas (ABG) is a test run on an arterial blood sample which can provide information on a patient's acid-base balance and ventilation by measuring the amount of oxygen, carbon dioxide, and bicarbonate present in the blood. ABG values can be difficult to interpret without some extra practice.
- pH: The normal range for pH is between 7.35 and 7.45.
- PaCO₂: The normal range for PaCO₂ is between 35 and 45 mmHg. PaCO2, which is the partial pressure of carbon dioxide.
- HCO₃: The normal range for HCO₃ is between 22 and 26 mEq/L. Then we have bicarbonate or HCO3.
- PaO₂: The normal range for PaO₂ is between 80 and 100 mmHg. Then we have our PaO2, which is the partial pressure of oxygen.
- SaO₂: The expected range for SaO₂ is between 95 - 100%. And then we have our SaO2, which is, really, the oxygen saturation of the arterial blood. SaO₂ is the measure of hemoglobin saturation in the arterial blood.
Pulse Oximetry
Pulse oximetry is another way to assess respiratory status. SaO₂ and SpO₂ are both a measurement of hemoglobin saturation in the blood. However, SpO₂ is measured with a pulse oximeter (a device that goes on the fingertip) so it is a much less invasive technique to collect this lab value than the arterial blood sampling that is needed with an ABG. Theoretically, these values should be the exact same. However, if we have a patient with COPD, they will often have SpO2 levels that are in the low 90s.
Bronchoscopy and Thoracentesis
Bronchoscopy
-Scopy comes from the Greek skopia/skopeo which means to view. So, any procedure ending in -scopy will involve the use of an instrument for viewing. Want to know more word hints to recognize unfamiliar terms? In terms of nursing care, pre-procedure we want to make sure the patient has been NPO for the prescribed amount of time, which varies between four and eight hours. Then post-procedure, we want to make sure that the patient's gag reflex has returned before we provide them anything to eat or drink. You also need to provide patient teaching that a sore, dry throat and blood-tinged mucus is expected. Post-bronchoscopy nursing care includes ensuring that the patient's gag reflex has returned before providing food or beverage and monitoring the patient for a pneumothorax.
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Thoracentesis
Pleural effusion is excess fluid in the pleural cavity that can make it hard to breathe. A thoracentesis may be done to treat the pleural effusion by removing the fluid, but also as a diagnostic procedure to collect the fluid for analysis to determine the cause of the effusion. For the procedure, a patient must sit upright, and their arms should be supported on their bedside table or on pillows. They also need to remain still. So pre-procedure, you want to have the patient sit upright, and their arms should be supported on their bedside table or on pillows. And during the procedure, they need to remain perfectly still. After the procedure, you're going to want to monitor them for complications such as a pneumothorax, bleeding, or hypotension. Post-thoracentesis, monitor the patient for complications like a pneumothorax, bleeding, or hypotension. A chest x-ray can be performed if complications are suspected.
NCLEX Practice Questions for Respiratory System
Welcome to your NCLEX Practice Exam for Respiratory System 1! Instant Feedback: After each question, the correct answer along with an explanation will be revealed. Time Limit: There is no time limit for this exam. Read each question carefully. Understand the rationale behind each answer. Don't be discouraged by incorrect answers. Take breaks if you need them. Remember, this exam is not just a test of your knowledge, but also an opportunity to enhance your understanding and skills. Click 'Start Exam' when you're ready to begin.
Nurse Jackson is preparing to administer I.V. vancomycin (Vancocin) to Mr. Daniels.
A.
B.
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C.
D. Vancomycin should be given over 1 to 2 minutes as an I.V.
Nurse Stevens is caring for John, a 45-year-old male patient with pneumonia who has developed respiratory failure. His partial pressure of arterial oxygen (PaO2) is 55 mm Hg, and he has been placed on mechanical ventilation with a fraction of inspired oxygen (FIO2) of 0.9. Nurse Stevens' goal is to reduce the FIO2 to a safer level.
A.
B.
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C.
D.
Nurse Lisa is caring for Mr. Anderson, who has a chest tube connected to a closed water-seal drainage system.
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B.
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D.
Nurse Davis is providing care for Mr. Harris, a patient with chronic obstructive pulmonary disease (COPD). Which nursing intervention would most effectively help maintain a patent airway for Mr.
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D.
Nurse Laura is reviewing the ABG results of Mr. Peterson, which show a pH of 7.5, PaCO2 of 26 mm Hg, O2 saturation of 96%, HCO3 of 24 mEq/L, and PaO2 of 94 mm Hg.
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B.
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D.
Nurse Patel is teaching Mrs. Wilson, a patient with emphysema, the proper technique for pursed-lip breathing. Mrs. Wilson is curious about the benefits of this breathing method and asks Nurse Patel to explain its purpose.
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Nurse Daniels is admitting Mr. Green, a patient with chronic obstructive pulmonary disease (COPD), to the healthcare facility. To prioritize his care, which nursing diagnosis is most crucial for Mr.
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Nurse Kim is administering a purified protein derivative (PPD) test to a homeless client. She needs to accurately inform the client about the implications of the test results.
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Nurse Patel is attending to Mr. Thompson, a patient with a chest tube in place following thoracic surgery. During her shift, the chest drainage system accidentally becomes disconnected.
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