![]() , See Figure 8.10 for an image of a chest X-ray.Ī sputum culture is a diagnostic test that evaluates the type and number of bacteria present in sputum. ![]() Chest X-rays are contraindicated during pregnancy. Health care providers also use chest X-rays to see how well certain treatments are working and to check for complications after certain procedures or surgeries. This test can help diagnose and monitor conditions such as pneumonia, heart failure, lung cancer, and tuberculosis. For example, patients with a productive cough may have a chest X-ray or sputum culture ordered, and patients experiencing respiratory distress often have arterial blood gas (ABG) tests performed.Ī chest X-ray is a fast and painless imaging test that uses certain electromagnetic waves to create pictures of the structures in and around the chest. See Figure 8.9 for an image of a barrel chest.įigure 8.9 Comparison of Chest with Normal Anterior/Posterior Diameter (A) to a Barrel Chest(B) Diagnostic Tests and Lab Workĭiagnostic tests and lab work are based on the patient’s medical condition that is causing the decreased oxygenation. A barrel chest results from air trapping in the alveoli. See Figure 8.8 for an image of clubbing.Īnother sign of chronic hypoxia that often occurs in patients with chronic obstructive pulmonary disease (COPD) includes an increased anterior-posterior chest diameter, often referred to as a barrel chest. Clubbing is the enlargement of the fingertips that occurs with chronic hypoxia such as in chronic obstructive pulmonary disease (COPD) or congenital deficits in pediatric patients. Signs of cyanosis or clubbing should be noted. Review detailed interview questions and how to perform a physical examination of the respiratory system in the “ Respiratory Assessment” chapter in the Open RN Nursing Skills textbook. ![]() Objective Assessmentįocused objective assessments for a patient experiencing decreased oxygenation include assessing airway, evaluating respiratory rate and heart rate, analyzing pulse oximetry readings, and auscultating lung sounds for adventitious sounds. If it is not a medical emergency, perform a focused assessment on the chest pain, including onset, location, duration, characteristics, alleviating or aggravating factors, radiation, and if any treatment has been used for the pain. If any of these symptoms are occurring, seek emergency medical assistance according to agency policy. “Do you feel short of breath, dizzy, or nauseated?”.“Is the pain radiating into your jaw or arm?”.“Does it feel like something is sitting on your chest?”.If the patient reports chest pain, first determine if it is an emergency by asking questions such as: Chest pain can occur with several types of respiratory and cardiac conditions, some which are emergent. Patients should be asked if they are experiencing chest pain. See Figure 8.7 for an image of purulent sputum. For example, sputum caused by a respiratory infection is often yellow or green and often referred to as purulent sputum. The color of a patient’s sputum can provide cues for underlying medical conditions. The body attempts to get rid of this excess by coughing it up as sputum. The body always produces mucus to keep the delicate tissues of the respiratory tract moist so small particles of foreign matter can be trapped and forced out, but when there is an infection in the lungs, an excess of mucus is produced. Sputumis mucus and other secretions that are coughed up from the mouth. If a cough is present, determine if sputum is present, and if so, the color and amount of sputum. It is also important to ask patients if they are experiencing a cough. There are many interventions that a nurse can implement to help improve the feeling of dyspnea and, thus, improve a patient’s overall quality of life. The feeling of dyspnea can be very disabling for patients. Patients can be asked to rate their dyspnea on a scale of 0-10, similar to using a pain rating scale. The primary symptom to assess when a patient is experiencing decreased oxygenation is their level of dyspnea, the medical term for the subjective feeling of shortness of breath or difficulty breathing. When assessing a patient’s oxygenation status, there are several subjective and objective assessments to include. Now that we have discussed various concepts related to oxygenation and hypoxia, we will explain how a nurse uses the nursing process to care for patients with alterations in oxygenation.
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