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Diag Pro Unit 7
SPC Diagnostic Procedures Exam 4 Unit 7
Question | Answer |
---|---|
What is bronchoscopy? | Procedure to diagnose or treat a variety of lung related disease. |
Pulmonologist is able to view what with a bronchoscope? | respiratory tract including larynx, vocal chords, trachea, & lobes |
Two types of bronchoscope procedures? | Therapeutic & Diagnostic |
What are rigid bronchoscopes? | Hollow & NOT flexible: often used for removal of foreign body of insert of equipment |
Rigid bronchoscopes are performed with the patient....? | Under general anesthesia in a surgical or operating room |
What are flexible bronchoscopes? | Most commonly used for bedside procedures with a long flexible end with 3 channels |
What are the 3 channels used for with a flexible bronchoscope? | 1. Light transmission 2. Visualizing channel 3. Multipurpose channe |
The multipurpose channel is used for what? | 1. Removal of secretions 2. tissue sampling 3. O2 admin |
Purpose of Bronchoscopy? | 1. Visual inspection of broncho tree 2. Remove object from airway 3. Collect fluid samples 4. Determine location and extent of lung damage 5. Insert a stent |
What is an airway stent? | A small tube that holds the airway open, used in situations where a tumor or other condition blocks the airway |
What is therapeutic bronchoscopy? | When used to treat or solve a medical issue |
Examples of therapeutic bronchoscopy? | 1. Removal excess secretions 2. Reduction of obstruction caused by cancer 3. Removal of foreign body 4. Verify proper placement of tube 5. Assistant in difficult intubation 6. Stent insertion |
What is diagnostic bronchoscopy? | When it is used to establish the cause of a problem |
Examples of diagnostic bronchoscopy? | 1. Evaluate pulmonary inflammation, infections, or chronic pneumonia 2. Extent of chest trauma 3. Obtain tissue samples 4. Bronchoalveolar lavage |
Indications for bronchoscopy? | 1. Evaluate atelectasis/lesions 2. Asses swelling 3. Investigate hemoptysis 4. Positive sputum cytology 5. Lower respiratory secretions, biopsies 6. Remove foreign body/mass 7. Place stent 8. Difficult intubations 9. Lung cancer staging |
Contraindications of bronchoscopy? | 1. No consent unless emergency 2. No experienced bronchoscopist 3. Lack of facilities/equipment/personnel 4. Cant Oxygenate proper |
Relative contraindications of bronchoscopy? | Procedure should only be preformed when benefits outweigh the risk: Coagulopathy, Refractory Hypoxemia, Unstable hemodynamic & arryhthmias |
Complications of bronchoscopy? | Hypoxemia, Irregular Heart rhythms, Bleeding, pneumo, fever, nausea, vomiting, pneumonia, airway edema, excessive lidocaine, respiratory arrest, vocal cord injury, death |
4 types of sample collections? | Washing, Brushing, Needle Aspiration, Forceps Biopsy |
Medications with bronchoscopy? | 1. Mucomyst 2. Lidocaine jelly/atomized/solution 3. Sterile H2O 4. Epinephrine 5. Nasonephrin 6. Liquid Cocaine |
Preparation for bronchoscopy? | Clean scope 1. PPE 2. Airway equipment 3. Syringes & needles 4. sterile H2O/saline 5. Cups & traps 6. Gauze 7. Bronch accessories 8. Meds |
Make sure bronchoscope is what before each use? | Clean & Sterilized |
How to perform a leak test with bronchoscope? | Place bronchoscope under pressure and set in sterile water, if bubbles are seen test has failed. |
Bronchoscope integrity? | 1. Check damage to optics and channels 2. Connect scope to light source 3. look through scope 4. If lens is cloudy wipe end with alchohal pad 5. If black dots appear then optic bundles in scope has been damaged scope is no good |
To prepare the patient the nurse will give what sedatives? | 1. Valium 2. Versed 3. Diprivan |
What happens to the FIO2 during bronchoscopy? | Increased to 100% |
The patients vitals are monitored when? | Before, during, & after procedure |
What should be monitored during bronchoscopy? | 1. Vital signs 2. Cardiac Rhythm changes 3. SPO2 & FIO2 4. Pain/discomfort/dyspnea 5. Mech/vent settings 6. Types & amounts of lavages |
What happens post bronch recovery? | 1. O2 therapy for up to 4hrs 2. SPO2 checked before discontinuing O2 3. Patient is NPO as long as airway remains numb to prevent aspirations 4. Routinely assessed for stridor & wheeze |
What treats stridor& airway edema? | Nebulized racemic epinephrine |