Keep abreast of diagnostic tests

77

Respiratory refresher (continued)

SARCOIDOSIS (CONTINUED)
Key interventions
Provide a nutritious, high-calorie diet and plenty of fluids. If the
client has hypercalcemia, suggest a low-calcium diet.
Administer O2.
SEVERE ACUTE RESPIRATORY SYNDROME
Key signs and symptoms
Chills
Fever
General discomfort
Headache
Shortness of breath

TUBERCULOSIS
Key signs and symptoms
Low-grade fever
Night sweats

Key test results

Laboratory validation includes cell culture of severe acute
respiratory syndrome (SARS)-associated coronavirus (SARSCoV), detection of SARS-CoV ribonucleic acid by the reverse
transcription polymerase chain reaction test, or detection of
serum antibodies to SARS-CoV.
Key treatments
Supplemental O2 including possible mechanical ventilation
Chest physiotherapy
Antibiotics
Antivirals
High doses of corticosteroids

Lobes: 3 and 2
As a unit, the lungs are composed of three
lobes on the right side and two lobes on the
left side. The lungs regulate air exchange by
a concentration gradient. In the alveoli, gases
move from an area of high concentration
to an area of low concentration. Because
the concentration of CO2 is greater in the
alveoli, it diffuses out into the lungs and is
exhaled. Because the lungs contain a greater
concentration of O2, O2 diffuses out of the
lungs and into the alveoli, to be carried to the
rest of the body.

Key interventions
Treat symptoms and support the client as needed.
Maintain a patent airway.
Follow contact and airborne precautions, including use of an
N-95 respirator for all health care professionals.
Monitor vital signs and respiratory status.

Key test results

Mantoux skin test is positive.
Stains and cultures of sputum, cerebrospinal fluid, urine,
abscess drainage, or pleural fluid shows heat-sensitive, nonmotile, aerobic, and acid-fast bacilli.
Key treatments
Standard and airborne precautions
Antituberculars: isoniazid, ethambutol (Myambutol), rifampin
(Rifadin), pyrazinamide
Key interventions
Maintain infection-control precautions; provide a negative
pressure room.
Assess respiratory status.
Provide O2 therapy.

lubricates the pleura to reduce friction during

respiration.

Keep abreast of
diagnostic tests
Here are the most important tests used to
diagnose respiratory disorders, along with
common nursing interventions associated
with each test.

A pleur-ality of coverings

Deep, direct visualization

Pleura refers to the membrane covering

the lungs and lining the thoracic cavity.
The pleura covering the lungs is known
as the visceral pleura, whereas the parietal
pleura lines the thoracic cavity. Pleural fluid

In bronchoscopy, the physician uses a bronchoscope to directly visualize the trachea and
bronchial tree. During bronchoscopy, the
physician may obtain biopsies and perform
deep tracheal suctioning.

313419NCLEX-RN_Chap04.indd 77

After any
invasive test involving
the airwaysuch
as bronchoscopy
assess respiratory
status to ensure the
clients safety.

4/8/2010 6:46:14 PM