The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [401]
a Early defibrillation to restart the heart.
a Early cardiopulmonary resuscitation.
a Administration of adrenaline every 3 minutes.
a Correction of reversible causes of hypoxia.
7 Why is it essential to humidify oxygen used during respiratory therapy?
a Oxygen is a very hot gas so if humidification isn’t used, the oxygen will burn the respiratory tract and cause considerable pain for the patient when they breathe.
b Oxygen is a dry gas which can cause evaporation of water from the respiratory tract and lead to thickened mucus in the airways, reduction of the movement of cilia and increased susceptibility to respiratory infection.
c Humidification cleans the oxygen as it is administered to ensure it is free from any aerobic pathogens before it is inhaled by the patient.
d Humidifying oxygen adds hydrogen to it, which makes it easier for oxygen to be absorbed to the blood in the lungs. This means the cells that need it for intracellular function have their needs met in a more timely manner.
These multiple choice questions are also available for you to complete online. Visit www.royalmarsdenmanual.com and select the Student Edition tab.
Answers to the multiple choice questions can be found in Appendix 3.
Part three
Supporting the Patient Through the Diagnostic Process
11 Interpreting diagnostic tests
12 Observations
Chapter 11
Interpreting Diagnostic Tests
Overview
In clinical practice nursing staff are required to instigate, participate or assist in the collection of body fluids and/or specimens for varying purposes. Diagnostic tests are undertaken to aid in diagnosis and treatment of various conditions. This chapter will discuss common diagnostic and microbiological tests encountered in clinical practice.
Diagnostic tests include blood sampling from a vein or from central venous access devices to determine the haematological and biochemical status of patients, lumbar puncture for diagnostic and treatment purposes, liver biopsy, semen collection and cervical swabbing. Depending on the clinical picture, other more invasive diagnostic procedures such as endoscopy or the need for radiological investigations such as X-ray may be required.
Microbiological tests are essential in determining infective organisms in body fluids, compartments or tissues that complicate treatment or that can be implicated in chronic conditions.
Diagnostic tests
Definition
A clinical specimen can be defined as any bodily substance, solid or liquid, that is obtained for the purpose of analysis (Weston 2008). Specimen collection is required when microbiological, biochemical or other laboratory investigations are indicated. The collection of an appropriate specimen for microbiological analysis allows for the isolation and identification of micro-organisms that cause disease, and the determination of antimicrobial sensitivity to guide the appropriate antibiotic treatment.
Related theory
A wide range of methods are available for obtaining cultures and identifying organisms from specimens or swabs. To employ all these tests would be time-consuming and costly, and therefore processing and analysis need to be selective. This is dependent on the type of specimen being processed, the patients’ clinical presentations, relevant history, recent or current antimicrobial therapy and investigation required. Based on this information, the microbiology laboratory can select the most appropriate culture media to isolate and identify pathogenic organisms, be they bacterial, viral, fungal or parasitic (Weston 2008). For example, a faecal sample from a patient who also has a history of recent travel would be investigated for organisms not normally looked for in a specimen from a patient without such a history. The sensitivity of the organism to a range of antimicrobials can then be tested to decide on the most appropriate and effective mode of treatment (Higgins 2007).