Question

Your patient is the 68 year old man from the previous challenge who had shortness of breath for the past 2 to 3 days. His clinical condition deteriorated further, requiring intubation. The health care provider orders a CT scan of the chest.

What are responsibities when preparing the patient for the CT scan?

Why is it important to monitor your patient using capnography?

A large fluid collection on the left side is found during the CT scan and a thoracentesis is planned. What are your responsibilities in preparing for and assisting with this procedure?

Your patient was extubated after the left thoracentesis. Within 12 hours he again develops respiratory distress, decreased breath sounds and a trachea that appears deviated to the right. What is your assessment?

Answer 1

1 ▪taking patient’s history

▪ obtaining informed consent,

▪prepare the patient

▪provide education

.*To ensure the safety and accuracy of the procedure

▪ Determine patient sensitivity to intravenous contrast

▪allergies to iodine (A contrast may either be an iodine-based or barium-sulfate compound that is taken orally, rectally, or intravenously which can enhance the visibility of specific tissues, organs, or blood vessels)

and renal function, including baseline creatinine level.

2.Capnography is a noninvasive measurement of carbon dioxide levels. This provides information about CO2 production, alveolar function, and respiratory patterns. It reflects changes in breathing effectiveness before hypoxia occurs.

3.▪Explain the procedure to the patient

▪verify that a consent has been obtained

▪determine allergies if a local anesthetic is to be used

▪properly position the patient (although this may be modified from a nonintubated patient's position).

4.Pneumothorax, partial or complete, is a complication that can occur within 24 hours of a thoracentesis. Tracheal deviation results as the thoracic structures are shifted away from the collapsed lung.