N-NF-II-125 Chapter Notes - Chapter 7: Personal Protective Equipment, Tracheotomy, Asepsis

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bsm5622

30 Oct 2022

School

Kerala University of Health Sciences - KUHS

Department

Nursing

Course

N-NF-II-125

Professor

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Document Summary

The following techniques are used to minimize or decrease suctioning complications: Suction only as needed: - because suctioning the client with an ett or tracheostomy is uncomfortable for the client and potentially hazardous because of hypoxemia, it should be performed only when indicated and not on a fixed schedule. Sterile technique: - infection of the lower respiratory tract can occur during tracheal suctioning. The nurse using sterile technique during the suctioning process can prevent this complication. No saline instillation: - instilling normal saline into the airway has been a common practice and a routine part of the suctioning procedure. It was thought that the saline would facilitate removal of secretions and improve the client"s oxygenation status. Research, however, has shown that saline instillation does not facilitate removal of secretions and causes adverse effects such as hypoxemia and increased risk of pneumonia.

Related Questions

Do any of these instructional notes apply to this scenario?

EXCLUDES: Lung removal with bronchoplasty (32501)

Code also decortication (32320)

Code also excision of chest wall tumor, when performed (21601-21603)

Documentation:

PREOPERATIVE DIAGNOSIS: Mass of lung

POSTOPERATIVE DIAGNOSIS: Carcinoma of the right lung

OPERATION PERFORMED: Bronchoscopy and right upper lobectomy

The patient was brought into the operating room, and after the

administration of anesthesia, the patient was prepped and draped in the usual sterile fashion. The patient was placed in the left lateral decubitus

position. A thoracotomy incision was made. This exposed the chest

muscles, which were incised and retracted. The fourth and fifth ribs were

visualized and transected to allow entrance to the chest. A tumor mass was

noted. This mass measured 7.0 cm in diameter, involving the right lung

upper lobe. The mass was excised in its entirety, and a biopsy of the mass

was taken and sent for frozen section. The frozen section revealed

squamous cell carcinoma. Nodes were then dissected around the pulmonary

artery and the trachea. The nodes were sent for frozen section. The nodes

were identified as negative per pathology. Saline was irrigated into the

chest. It was noted that the liver and diaphragm appeared to be normal with

no lesions seen. After verification that the sponge count was correct, chest

tubes were placed for drainage. The surgical wound was closed in layers

with chromic catgut and nylon. The patient tolerated this portion of the

procedure well.

The patient was then placed in the supine position for the bronchoscopy.

The patient was still under anesthesia. A flexible fiberoptic bronchoscope

was inserted. Patient bronchi were noted bilaterally. The scope was

withdrawn. The patient was awakened and sent to the recovery area in

stable condition.

a. Yes

b. No

StewartRenee

Include the following in your Day-in-the-Life Scenario:

In what setting are you located?

Who are your most regular patients?

What is the problem the client is presenting, e.g., weak heart due to perfusion/bypass, lack of range of motion due to knee injury, etc.?

What kind of very general activities would you prescribe?

What is the description of at least one tool from the list in the lesson, along with an interpretation of the data it produces? (You may need to do additional research, so be sure to include a list of Works Cited for your teacher.)

What is a situation in which there is a potential hazard for one of your clients, and how did you respond to that situation? This could be a heart attack, a fainting spell, dangerous equipment, etc.

What is a situation in which you had to work with another member of the health team in order to get the best outcome for your patient?

What is a situation in which you had to educate the patient on what kind of exercise you were providing and why?

What ethical situation came about in which you had to check out the ASEP Code of Ethics, or, base your reaction on your own understanding of past ethical discussions?

What situation occurred in which you had to explain certification and licensure to the client?

You can combine all of these sections into interaction with just one client or describe a whole day with various clients

rose

What procedure(s) will you need to code? (Check all that apply.)

Documentation:

PREOPERATIVE DIAGNOSIS: Mass of lung

POSTOPERATIVE DIAGNOSIS: Carcinoma of the right lung

OPERATION PERFORMED: Bronchoscopy and right upper lobectomy

The patient was brought into the operating room, and after the

administration of anesthesia, the patient was prepped and draped in the usual sterile fashion. The patient was placed in the left lateral decubitus position. A thoracotomy incision was made. This exposed the chest muscles, which were incised and retracted. The fourth and fifth ribs were visualized and transected to allow entrance to the chest. A tumor mass was noted. This mass measured 7.0 cm in diameter, involving the right lung pper lobe. The mass was excised in its entirety, and a biopsy of the mass vas taken and sent for frozen section. The frozen section revealed quamous cell carcinoma. Nodes were then dissected around the pulmonary artery and the trachea. The nodes were sent for frozen section. The nodes were identified as negative per pathology. Saline was irrigated into the chest. It was noted that the liver and diaphragm appeared to be normal with

no lesions seen. After verification that the sponge count was correct, chest tubes were placed for drainage. The surgical wound was closed in layers with chromic catgut and nylon. The patient tolerated this portion of the procedure well The patient was then placed in the supine position for the bronchoscopy.

The patient was still under anesthesia. A flexible fiberoptic bronchoscope was inserted. Patient bronchi were noted bilaterally. The scope was withdrawn. The patient was awakened and sent to the recovery area in stable condition.

a. Bronchoscopy

b. Lobectomy

c. Excision

d. Biopsy

StewartRenee

N-NF-II-125 Chapter Notes - Chapter 7: Personal Protective Equipment, Tracheotomy, Asepsis

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