Ateneo de Zamboanga University

College of Nursing NURSING SKILLS OUT

I. DESCRIPTION Bronchoscopy (bron-KOS-ko-pee) is a procedure that allows your doctor to look inside your lungs' airways, called the bronchi (BRONG-ki) and bronchioles (BRONG-ke-ols). The airways carry air from the trachea (TRA-ke-ah), or windpipe, to the lungs. During the procedure, your doctor inserts a thin, flexible tube called a bronchoscope into your nose or mouth. The tube is passed down your throat into your airways. If you have a breathing tube, the bronchoscope can be passed through the tube to your airways. Youll be given medicine to make you relaxed and sleepy during the procedure. The bronchoscope has a light and small camera that allows your doctor to see your windpipe and airways and take pictures. If you have a lot of bleeding in your lungs or a large object stuck in your throat, your doctor may use a bronchoscope with a rigid tube. The rigid tube, which is passed through the mouth, is wider. This allows your doctor to see inside it more easily, treat bleeding, and remove stuck objects. A rigid bronchoscopy usually is done in a hospital operating room using general anesthesia (AN-es-THE-ze-ah). The term "anesthesia" refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep. Bronchoscopy is a safe procedure. Side effects and complications usually are minor. You may feel hoarse and have a sore throat after the procedure. Minor bleeding, infection, and fever also can occur. A rare, but more serious risk is a pneumothorax (noo-mo-THORaks), or collapsed lung. In this condition, air collects in the space around the lungs, which causes one or both lungs to collapse. II. MATERIALS / EQUIMENTS NEEDED:
Bronchoscope General / Local Anesthetic Rigid tube Syringe Needle Brush Forceps Sterile drapes Mouthpiece

III. PROCEDURE
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Explain procedure to the client. Ask to lie on your left side Give an intravenous sedative A local anesthetic is often given to anesthetise the mucous membranes of the pharynx, larynx, and trachea. A mouthpiece may be put between the teeth to stop the accidental biting of the endoscope Suctioning may be used during the procedure to clear saliva from the mouth A flexible bronchoscope is inserted with the patient in a sitting or supine position. Once the bronchoscope is inserted into the upper airway, the vocal cords are inspected. When the endoscope is passed down into the stomach, you may feel uncomfortable or may retch. Ask the patient to breathe slowly and deeply to relax the stomach muscles. If an abnormality is discovered, it may be sampled, using a brush, a needle, or forceps. Specimen of lung tissue (transbronchial biopsy) may be sampled using a real-time x-ray (fluoroscopy) or an electromagnetic tracking system.

IV. DIAGRAM / ILLUSTRATIONS

A flexible, pediatric bronchoscope is inserted through the patient's nose until the pharyngeal cuff of the laryngeal tube is seen (left) and briefly deflated allowing the bronchoscope to pass (middle). Finally, the endotracheal tube is advanced over the bronchoscope into the trachea, the pharyngeal cuff deflated again, and the laryngeal tube removed from the airway (right).

V. NURSING RESONSIBILITIES

1. Nurses will monitor the patient closely for 2 to 4 hours following

the procedure. 2. Monitor the patient until the effects of sedative drugs wear off and the gag reflex has returned. 3. Once the patient is released to go home, tell the patient they should not drive. Effects of the sedative medications may be lingering.

Reference:

http://www.emedicinehealth.com/bronchoscopy/page5_em.htm# after_the_procedure
http://www.leukemiabmtprogram.org/patients_and_family/procedures_diagno stic_tests/endoscopy.html

June 29, 2013 Date

MRS. CHARLITA AHMAD, RN Clinical Instructor MICHELLE ERIKA F. MEJIA BSNIII B