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80 Respiratory system

nitrogen, creatinine, protein, albumin, osmo-lality, and alpha1-antitrypsin.

Nursing actions Explain the procedure to the client. Withhold food and fluids before the procedure, as directed. Check the site for bleeding after the procedure.

Analyzing blood, part BA hematologic study uses a blood sample to analyze red blood cell (RBC) and white blood cell (WBC) counts, prothrombin time (PT), international normalized ratio (INR), partial thromboplastin time (PTT), erythrocyte sedi-mentation rate (ESR), platelet count, hemo-globin (Hb) level, and hematocrit (HCT).

Nursing actions Explain the procedure to the client. Note current drug therapy before the procedure. Check the venipuncture site for bleeding after the procedure.

Polish up on client careMajor respiratory disorders include acute respiratory distress syndrome (ARDS), acute re spiratory failure, asbestosis, asphyxia, asthma, atelectasis, bronchiectasis, chronic bronchitis, cor pulmonale, emphysema, idiopathic pulmonary fibrosis (IPF), lung cancer, pleural effusion and empyema, pleurisy, Pneumocystis carinii pneumonia (PCP), pneumonia, pneumothorax and hemothorax, pulmonary edema, pulmonary embolism, respiratory acidosis, respiratory alkalosis, sarcoidosis, severe acute respiratory syndrome (SARS), and tuberculosis.

Acute respiratory distress syndrome

In ARDS, fluid builds up in the lungs and causes them to stiffen. This impairs breathing, thereby reducing the amount of O2 in the cap-illaries that supply the lungs. When severe,

Nursing actionsBefore the procedure Explain the procedure to the client. Withhold food and fluids for 8 hours. Make sure that written, informed consent has been obtained.After the procedure Monitor and record vital signs and pulse oximetry. Assess respiratory status (checking for signs of pneumothorax, air embolism, hemop-tysis, and hemorrhage). Check the incision site for bleeding.

Taking a pulsePulse oximetry is a noninvasive test that measures oxygen saturation of hemoglobin with a laser device. The device is applied to the finger, ear, bridge of the nose, or forehead.

Nursing actions Explain the procedure to the client. Monitor readings intermittently or continuously.

Taking a snoozeA sleep study test is performed in a sleep laboratory and monitors the clients body while he sleeps. Its commonly used to diag-nose obstructive sleep apnea.

Nursing actions Explain the procedure to the client. Tell the client what supplies to bring from home, such as pajamas. Instruct the client to limit his intake of caf-feine, nicotine, and alcohol on the day of the test.

Analyzing blood, part AA blood chemistry test assesses a blood sample for potassium, sodium, calcium, phosphorus, glucose, bicarbonate, blood urea

Clients with ARDS should be kept in a prone position.

313419NCLEX-RN_Chap04.indd 80313419NCLEX-RN_Chap04.indd 80 4/8/2010 6:46:15 PM4/8/2010 6:46:15 PM

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