Hi, I'm Cathy with Level Up RN. In this video,
we are going to talk about respiratory system diagnostic tests and labs. At the end of the
video, I'm going to give you guys a little quiz to test your knowledge of some of the facts I'll
be going over in this video. Let's start off by talking about arterial blood gases or ABGs. So
I actually have a whole other playlist that is totally dedicated to ABGs and interpreting
ABGs. So if you need any help with that, then definitely check that out at some point.
So ABGs assesses the acid-base balance and the oxygenation of critical-care patients and patients
with acute or chronic respiratory disorders using a sample of their arterial blood. There are
five key components of ABGs. The first is the pH, which should be between 7.35 and 7.45. Then
we have PaCO2, which is the partial pressure of carbon dioxide. That should be between
35 and 45. Then we have bicarbonate or HCO3. That should be between 22 and 26. Then
we have our PaO2, which is the partial pressure of oxygen. That should be between 80 and 100.
And then we have our SaO2, which is, really, the oxygen saturation of the arterial blood.
That should be between 95 and 100 percent. So another way that we can assess our patient's
respiratory status is through pulse oximetry. So the patient's SpO2 should be between 95 and 100
percent. However, if we have a patient with COPD, they will often have SpO2 levels that are in the
low 90s. And that is expected for a patient with this condition. And then lastly, we have pulmonary
function tests or PFTs, and these can be really helpful in diagnosing asthma and COPD in patients.
All right. Now, let's talk about a bronchoscopy, which is insertion of a tube into the patient's
airway that allows for visualization of that airway as well as the collection of specimens.
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. We also want to provide
the prescribed medications which allow for sedation of the patient during the procedure.
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. And then, of course, you want to monitor your
patient for complications such as a pneumothorax, which we will talk more about as we go into detail
about critical-care topics in this video playlist. Next, let's talk about a thoracentesis, which
involves the insertion of a needle into the patient's posterior chest to remove fluid or air
from the pleural space. 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. So you need to advise them not to talk, move, or cough when the thoracentesis
is being performed. After the procedure, you're going to want to monitor them for complications
such as a pneumothorax, bleeding, or hypotension. A chest x-ray can be performed if complications
are suspected. And then you want to advise your patient to take nice, big, deep breaths to
help expand those lungs after the procedure. Okay. You guys ready for your quiz?
I have three questions for you. First question. An SpO2 of 90% is an expected
finding in a patient with COPD. True or false? The answer is true.
Question number two. Before allowing a patient to eat or drink after a
bronchoscopy, what assessment do you need to make? The answer is you need to make sure that
the patient's gag reflex has returned. Question number three. How would you
position your patient for a thoracentesis? The answer is you would have
them sit upright with their arms supported on the bedside table or on pillows.
So hopefully you did well on that quiz. If not, you can go back and watch the video or review our
cards again. Take care, and good luck studying. I invite you to subscribe to our channel
and share a link with your classmates and friends in nursing school. If you found value
in this video, be sure and hit the like button, and leave a comment and let us know
what you found particularly helpful.