Summary ATI Chapter 18: Respiratory Diagnostic Procedures

ATI Chapter 18: Respiratory Diagnostic Procedures I. Overview A. Respiratory diagnostic procedures: used to evaluate a client’s respiratory status by checking indicators such as the oxygenation of the blood, lung functioning, and the integrity of the airway B. Respiratory diagnostic procedures that nurses be knowledgeable about include: 1. Pulse oximeter 2. ABGs 3. Bronchoscopy 4. Thoracentesis II. Pulse oximetry: noninvasive measurement of the oxygen saturation of the blood, but it is not a replacement for ABG measurement A. A battery or electric-operated device with a sensor probe that is attached securely onto the client’s fingertip, toe, bridge of nose, earlobe, or forehead with a clip or band B. Purpose: 1. Measure arterial oxygenation saturation (SaO2) via a wave of infrared light that measures light absorption by oxygenated and deoxygenated Hgb in arterial blood. SaO2 and SpO2 are used interchangeably C. Indications 1. Conditions or situations in which a client’s respiratory status should be monitored, such as during a continuous opioid epidural infusion 2. The following s/sx indicate oxygen saturation should be monitored: a. ↑ work of breathing b. Wheezing c. Coughing d. Cyanosis D. Interpretation of findings 1. The expected reference range for SaO2 is 95-100%. Acceptable levels may range from 91-100%. Some illnesses even allow 85-89% 2. Reasons values may be lower: a. Elderly clients and those with dark skin b. Other reasons: hypothermia, poor peripheral blood flow, too much light (sum or infrared lights), low Hgb, client movement, edema, and nail polish 3. Values obtained are unreliable in cardiac arrest, shock, and other states of low perfusion a. The lower the SaO2 level, the less accurate the value 4. Interventions required: a. An SaO2 below 91% requires interventions b. An SaO2 below 86% is an emergency c. An SaO2 below 80% is life-threatening III. Arterial Blood Gases (ABGs): reports the status of oxygenation and acid-base balance of the blood A. An ABG measures: 1. pH: the amo