University of Scranton

Department of Nursing

Nursing 350

Respiratory Nursing Care Laboratory Study Guide

This is a required assignment that must be turned into your clinical instructor.
 
Name  

1. What should be included in preoperative instructions to a patient about deep breathing exercises? (See Black)
 
 
 

2. What positions should a patient be placed in order for chest physiotherapy to be effective for each of the lobes of the lungs? (See Craven & Hirnle)
 
Lobe Position
Right Upper  
Right Middle  
Right Lower  
Left Upper  
Left Lower  

3.    Which positions for chest physiotherapy might be poorly tolerated by COPD, cardiac or head injury patients?
 
 
 

4.    What should be included in a respiratory assessment?
 
 

See Video: Airway Management:  Chest tubes RD536.A4 in the Media Center
 

5.    What specific observations should be included for a patient who has a chest tube? (See Black)
 
 
 

6.    A patient with a chest tube requires an X-ray which cannot be done at the bedside.  The licensed practical nurse wants to clamp the chest tube while the patient is transported to the Radiology Department.  What is your recommendation? (See Black)
 
 
 
 

7.  A patient's chest tube becomes separated from the drainage tubing.  What is the most appropriate nursing action?
 
 
 
 

8.    What specific exercises should be done by a patient with a chest tube to prevent frozen shoulder? (See Black)
 
 
 

9.    What type of dressing is applied to the site after a chest tube is removed?
 
 
 

See Craven & Hirnle and the following article to answer the questions about suctioning:

Glass, C.A., & Grap, M.J. (1995).  Ten tips for safer suctioning. American Journal of Nursing, 95(5), 51-53.

10.    What is the appropriate size suction catheter and amount of suction to be used for endotracheal suctioning in an adult?
 
Catheter Size
Amount of Suction
   

11.      How long should a patient be oxygenated before and after suctioning?
 
 
 

12.    While suctioning a patient, he coughs and his color becomes dusky.  What is the most appropriate action?
 
 
 
 

13.      Which patients might be at risk for developing an arrhythmia after suctioning?
 
 
 

14.    What is the maximum time permitted for suctioning?
 
 
 
 
 
 

15.    What protective equipment required for respiratory isolation? (See Craven & Hirnle)
 
 
 

16.      List the sequence of activities for donning and removing complete protective gear for respiratory isolation?
 
 
Donning Gear
Removing Gear
   
   
   
   
   

See the following article to answer #21
Jones, L. & Hannum, D. (1998).  Playing it safe with a particulate respirator.  Nursing 98, 28(1), 50-52.

17.    How long may a particulate respiratory be worn?
 
 
 
 

18.    A patient in the post-anesthesia care unit has a pulse oximeter reading of 86. What does this mean and what would you do?
 
 
 



The following are to be answered and turned in to your clinical instructor after the completion of the laboratory.
19.     While attempting to suction a patient the nurse has difficulty inserting the catheter into the nares and blood is observed in the connecting tubing.  What is the most appropriate action?
 
 
 
 
 

20.    What should be included in a narrative note of patient who needs frequent suctioning?
 
 
 
 
 

See this article to answer # 23:
Carroll, P. (2000). Guest editorial. Should suctioning be left to the nurse? (2000). American Journal of Critical Care, 9(2), 85-86.
 

21.    What does the research literature in nursing say about instilling saline when suctioning someone who has a tracheostomy?
 
 
 
 
 
 
 
 
 

See the following article for answers to # 24 & 25

Pettinicchi, T. (1998).   Troubleshooting chest tubes. American Journal of Nursing, 98(3), 58-59.

22.   In caring for a patient with a chest tube, the suction is to be set at 20 cm. It is observed that the fluid level in the suction control chamber is 15 cm.
        What is the most appropriate action?
 
 
 

        What might happen if no action is taken?
 
 

23.    How would you check for an air leak in a chest tube?  See reference books available in the lab (Smith & Duell) for the answer.
 
 
 

Copyright © 2001 Margarete Lieb Zalon

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