Page 1572 - Saunders Comprehensive Review For NCLEX-RN

1. Description: Removal of fluid or air from the pleural
space via transthoracic aspiration
2. Preprocedure
a. Prepare the client for ultrasound or
chest radiograph, if prescribed, before
the procedure.
b. Assess results of coagulation studies.
c. Note that the client is positioned sitting
upright, with the arms and shoulders
supported by a table at the bedside
during the procedure (Fig. 50-1).

d. If the client cannot sit up, the

client is placed lying in bed toward the
unaffected side, with the head of the
bed elevated.
e. Instruct the client not to cough, breathe
deeply, or move during the procedure.
3. Postprocedure
a. Monitor respiratory status.
b. Apply a pressure dressing, and assess
the puncture site for bleeding and
crepitus.
c. Monitor for signs of

pneumothorax, air embolism, and
pulmonary edema.
H. Pulmonary function tests
1. Description: Tests used to evaluate lung mechanics,
gas exchange, and acid–base disturbance through
spirometric measurements, lung volumes, and arterial
blood gas levels.
2. Preprocedure

a. Determine whether an analgesic

that may depress the respiratory
function is being administered.
b. Consult with the PHCP regarding
withholding bronchodilators before
testing, or alternatively if the testing
will be done prior to and after
administration of a bronchodilator.
c. Instruct the client to void before the
procedure and to wear loose clothing.
d. Remove dentures.
e. Instruct the client to refrain from
smoking or eating a heavy meal for 4

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