Hi, I'm Cathy with Level Up RN. In this video, we are going to talk about respiratory system
diagnostic tests and labs. At the end of the video, I'm going to give you guys a little quiz
to test your knowledge of some of the facts I'll be going over in this video. Let's start off by
talking about arterial blood gases or ABGs. So I actually have a whole other playlist that is
totally dedicated to ABGs and interpreting ABGs. So if you need any help with that,
then definitely check that out at some point. So ABGs assesses the acid-base balance and the
oxygenation of critical-care patients and patients with acute or chronic respiratory disorders
using a sample of their arterial blood. There are five key components of ABGs. The first is the pH,
which should be between 7.35 and 7.45. Then we have PaCO2, which is the partial pressure
of carbon dioxide. That should be between 35 and 45. Then we have bicarbonate or
HCO3. That should be between 22 and 26. Then we have our PaO2, which is the partial pressure
of oxygen. That should be between 80 and 100. And then we have our SaO2, which is, really,
the oxygen saturation of the arterial blood. That should be between 95 and 100 percent.
So another way that we can assess our patient's respiratory status is through pulse oximetry. So
the patient's SpO2 should be between 95 and 100 percent. However, if we have a patient with COPD,
they will often have SpO2 levels that are in the low 90s. And that is expected for a patient with
this condition. And then lastly, we have pulmonary function tests or PFTs, and these can be really
helpful in diagnosing asthma and COPD in patients. All right. Now, let's talk about a bronchoscopy,
which is insertion of a tube into the patient's airway that allows for visualization of that
airway as well as the collection of specimens. In terms of nursing care, pre-procedure we want
to make sure the patient has been NPO for the prescribed amount of time, which varies between
four and eight hours. We also want to provide the prescribed medications which allow
for sedation of the patient during the procedure. Then post-procedure, we want to make sure that
the patient's gag reflex has returned before we provide them anything to eat or drink. You also
need to provide patient teaching that a sore, dry throat and blood-tinged mucus is expected.
And then, of course, you want to monitor your patient for complications such as a pneumothorax,
which we will talk more about as we go into detail about critical-care topics in this video playlist.
Next, let's talk about a thoracentesis, which involves the insertion of a needle into the
patient's posterior chest to remove fluid or air from the pleural space. So pre-procedure, you want
to have the patient sit upright, and their arms should be supported on their bedside table or
on pillows. And during the procedure, they need to remain perfectly still. So you need to advise them
not to talk, move, or cough when the thoracentesis is being performed. After the procedure, you're
going to want to monitor them for complications such as a pneumothorax, bleeding, or hypotension.
A chest x-ray can be performed if complications are suspected. And then you want to advise your
patient to take nice, big, deep breaths to help expand those lungs after the procedure.
Okay. You guys ready for your quiz? I have three questions for you.
First question. An SpO2 of 90% is an expected finding in a patient with COPD. True or false?
The answer is true. Question number two.
Before allowing a patient to eat or drink after a bronchoscopy, what assessment do you need to make?
The answer is you need to make sure that the patient's gag reflex has returned.
Question number three. How would you position your patient for a thoracentesis?
The answer is you would have them sit upright with their arms
supported on the bedside table or on pillows. So hopefully you did well on that quiz. If not,
you can go back and watch the video or review our cards again. Take care, and good luck studying.
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