tailieunhanh - Ebook Essentials of critical care nursing - A holistic approach: Part 2

(BQ) Part 2 book "Essentials of critical care nursing - A holistic approach" presentation of content: Respiratory system, renal system, nervous system, gastrointestinal system, endocrine system, hematological and immune systems, integumentary system, multisystem dysfunction. | Respiratory System FOUR CHAPTER 15 Patient Assessment: Respiratory System OBJECTIVES Based on the content in this chapter, the reader should be able to: 1 Describe the components of the history for respiratory assessment. 2 Explain the use of inspection, palpation, percussion, and auscultation for respiratory assessment. 3 Explain the components of an arterial blood gas and the normal values for each component. 4 Compare and contrast the arterial oxygen saturation and the partial pressure of oxygen dissolved in arterial blood. 5 Compare and contrast the causes, signs, and symptoms of respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis. 6 Analyze examples of an arterial blood gas result. 7 Discuss the purpose of pulse oximetry, end-tidal carbon dioxide monitoring, and mixed venous oxygen saturation monitoring. 8 Discuss the purpose of respiratory diagnostic studies and associated nursing implications. 207 207 2/4/2012 3:12:16 PM 208 P A R T F O U R Respiratory System TA B L E 1 5- 1 Sputum Assessment History Sputum Appearance Significance Yellow, green, brown Clear, white Yellow Rust colored (yellow mixed with blood) Mucoid, viscid, blood streaked Persistent, slightly blood streaked Clotted blood present Bacterial infection Absence of infection Possible allergies Possible tuberculosis Principal symptoms to investigate in more detail commonly include dyspnea, chest pain, sputum production (Table 15-1), and cough. Because smoking has a significant impact on the patient’s respiratory health, the patient’s use of tobacco should be quantified by amount and how long the patient has smoked. Elements of the respiratory history are summarized in Box 15-1. A pulmonary illness often results in the production (or a change in the production) of sputum. Viral infection Carcinoma Pulmonary infarct Physical Examination A comprehensive pulmonary assessment allows the nurse to establish the patient’s baseline .

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