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MEDICAL MANAGEMENT
OXYGEN THERAPY
July 13, 2013
NURSING RESPONSIBILITIES
1. Place an Oxygen in use at the
clients bedside
2. Assessment:
Skin and mucus membrane
Breathing Patterns
Chest movement
Lung sounds
Presence of clinical signs of
hypoxemia
Presence of clinical signs of O2
toxicity
DIET
Iron rich foods with increased Oral Fluid Intake as
tolerated
Rationale:
Iron is an important mineral for all body cells--especially
red blood cells. Iron helps red blood cells make
hemoglobin, which helps to oxygenate your body
tissues.
Type of
Solution
D5LR
(5%
Dextrose in
Lactated
Ringers
Solution)
Classification
-Hypertonic
-Non
pyrogenic
-Parenteral
fluid
-Electrolyte
and nutrient
replenisher
Components
Electrolytes in
1000ml
Sodium 130
mmol
Potassium
4mmol
Calcium 1.4
mmol
Chloride
109mmol
Lactate
28mmol
Indications
Dosage
Contraindica
&
tions
Frequen
cy
Nursing
Responsibilities
Mechanism of
Action
Hypertonic
Solutions are those
that have an
effective osmolarity
greater than the
body fluids. This
pulls the fluid into
exercised in the
the vascular by
administration of
osmosis resulting in
parenteral fluids
an increased
-Solution containing vascular volume. It
dextrose should be raises the
intravascular
used with caution
osmotic pressure
and provides fluid
-Discard unused
electrolytes and
portion
calories for energy
LABORATORY EXAMS
PROCEDURES
The skin surface is cleansed with Antiseptic; A tourniquet is placed around the upper arm
to apply pressure
A needle is inserted through the area of cleansed skin into the vein below where the
tourniquet is applied. The blood is then pulled from the vein via the needle by gently
pulling the plunger on the syringe or by a connection of the needle to a special vacuum
vial that collects the blood.
After the procedure, the tourniquet is removed.
The venipuncture site is covered with cotton or a bandage to compress the site to stop the
bleeding.
The sample is then taken to the laboratory for analysis, and the complete blood count
results may be available within hours after collection. *Prompt delivery of the blood
sample to the laboratory for analysis is important. A sample that is not delivered in a
timely manner may yield inaccurate results.
NURSING INTERVENTIONS
Explain test procedure. Explain that slight discomfort may be felt when the
skin is punctured.
Encourage to avoid stress if possible because altered physiologic status
influences and changes normal hematologic values.
Explain that fasting is not necessary. However, fatty meals may alter some
test results as a result of lipidemia.
Apply manual pressure and dressings over puncture site.
Monitor the puncture site for oozing or hematoma formation.
Instruct to resume normal activities and diet.
HEMATOLOGY RESULTS
Date Performed
Component
Normal Range
Result
Analysis
Hgb
14-18 g/dl
8.5 g/dl
Decreased; due to
impaired gas exchange
Hct
40.0-54.0 %
25.0
WBC
4.0 10.0
5.2
Normal
Granulocyte
44.2 80.2 %
62.0
Normal
Lymphocyte
28.0 48.0 %
37.0
Normal
Monocyte
1-2%
Eosinophils
1-3%
1.0
Normal
Platelet
150-400 x 109/L
220.0
Normal
Blood Type
Clotting Time
Bleeding Time
Date Performed
Component
Normal Range
Result
Analysis
Hgb
14-18 g/dl
6.1 g/dl
Decreased; due to
impaired gas
exchange
Hct
40.0-54.0 %
18.0
Decreased; due to
blood loss
WBC
4.0 10.0
Granulocyte
44.2 80.2 %
Lymphocyte
28.0 48.0 %
Monocyte
1-2%
Eosinophils
1.4%
Platelet
150-400 x 109/L
Blood Type
Clotting Time
Bleeding Time
Date Performed
Component
Normal Range
Result
Analysis
Hgb
14-18 g/dl
7.8 g/dl
Decreased; due to
impaired gas
exchange
Hct
40.0-54.0 %
23.0
Decreased; due to
blood loss
WBC
4.0 10.0
Granulocyte
44.2 80.2 %
Lymphocyte
28.0 48.0 %
Monocyte
1-2%
Eosinophils
1.4%
Platelet
150-400 x 109/L
Blood Type
Clotting Time
Bleeding Time
CHEST X-RAY
A painless, non-invasive test that
creates picture of the structures
inside your chest such as your heart,
lungs and blood vessels.
Purpose:
This test is done to find the cause of
symptoms such as shortness of
breath, chest pain and chronic
cough.
PROCEDURES
The patient is typically instructed to wear a gown and remove all metal containing
objects around the upper body as these will interfere with the visualization of the
tissues. No other specific preparation, such as fasting, is necessary for a routine
chest x-ray.
The patient is then asked by the technician to stand in front of a surface adjacent to
the film that records the images. The front of the chest is closest to the surface.
Another part of the machine that releases radiation is then placed about 6 feet away,
behind the patient when the positioning is appropriate (normal standing position with
arms on the sides)
The technician may advise the patient to take a deep breath, and hold it and then
takes the image by activating the device (similar to taking a regular photograph)
NURSING RESPONSIBILITIES
Inform the client about the
procedure
Attend to the clients comfort
Assess vital signs and client
stability
Record and report data
Report of X-ray
Examination
Chest PA:
Examination shows fibrotic infiltrates at the left upper
lung
Examination: Chest PA
BLOOD SCREENING
A blood screening is a medical
process in which blood is
scanned to test for a particular
disease or condition.
Malaria: Negative
HBSAg : Non Reactive
RPR: Non Reactive
A HCV: Non Reactive
BLOOD TRANSFUSION
A blood transfusion is a safe, common
procedure in which you receive blood
through an intravenous (IV) line inserted into
one of your blood vessels.
Date: 07-13-2013 ; 8:50pm
Blood Bag Serial No. : 13-1594
Preparation: Fresh Whole Blood
Patients Blood Type: O+
Donors Blood Type: O+