Tumor on rib

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Tumor on rib lung thorascopy
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Thoracentesis

• Purpose
• Remove fluid for dx
• Remove fluid for tx
• Obtain biopsy
• Instill meds

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Thoracentesis

• Nrs Management
• Position patient
• Support
• Post-op
• Vital signs q 15
• Chest x-ray
• Breath sounds bilateral
• Cover site
• Check bleeding
• Check drainage

4
Thoracentesis
5
Thoracentesis
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Lab Values

• Sputum
• WBC
• Hemoglobin
• Hematocrit
• ABGs
• PTT/PT

7
Sputum studies

• Check for
• Pathogens
• CS
• Acid-fast bacillus
• What?
• TB
• Duration
• 4-6 wks

8
White Blood Cell Count

• Normal
• 5,000 10,000 cell/mm3
• Elevated
• Bacterial infection
• Decreased
• Leukemia
• Viral infection

9
Hemoglobin

• Normal
• Female 12-16 g/dl
• Male14-18 g/dl
• Elevated
• COPD
• Dehydration
• Decreased
• Anemia
• Hemorrhaging
• Over hydration

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Hematocrit

• Normal
• Female 37-37
• Male 42-52
• Elevated
• Dehydration
• Burns
• COPD
• Decreased
• Anemia
• Leukemia

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Arterial Blood Gases

• Purpose
• Adjust O2 levels
• Hypoxemia
• Description
• Must by arterial blood

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Arterial Blood Gases

• Values
• pH
• PaO2
• PaCO2
• HCO3-
• SaO2

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ABGs

• pH
• Normal
• 7.35-7.45
• Elevate
• gt 7.45
• Alkalosis
• Decreased
• lt7.35
• Acidosis

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pH Quiz Acidosis or alkalosis

• Arterial blood pH of 7.51?
• Alkalosis
• Arterial blood pH of 7.30?
• Acidosis
• Arterial blood pH of 7.34
• Acidosis
• Arterial blood pH of 7.43
• Normal / homeostasis

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ABGs

• PaO2
• Normal
• 80-100 torr
• Elevated
• Hypervenilation
• Decreased
• i resp. function
• Hypoxemia

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ABGs

• PaCO2
• Normal
• 35-34 mmHg
• Elevated
• Impaired gas exchange
• Decreased
• Hyperventilation

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ABGs

• HCO3-
• Normal
• 22-26
• SaO2
• Normal
• 95-100
• Decreased
• Hypoxemia

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PTT/PT Partial Thromboplastin Time

• Prolonged
• Liver disease
• Vit K deficiency
• Anticoagulant
• Hemophilia

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Quiz?

• The main function of platelets is to
• Provide oxygen to tissue
• Fight viral infections
• Fight bacterial infections
• Form a blood clot
• Platelets adhere to one another and play a very
  important role in coagulation