Respiratory System Procedures


You are a nurse working in a PCU. Your clinical unit specializes in the care of patients who are undergoing treatment for pulmonary disease. You often provide care and patient teaching for patients having tests and procedures for pulmonary conditions.

Your assignment today includes providing care and education support for 2 patients.

You have a student nurse observing in your unit today. As you teach, please be sure to include rationales and answer the student’s questions.

The Task

Patient 1:

Mr. Paul Monary, a 58 year old farmer, was admitted to your unit with complaint of progressive hoarseness, difficulty in swallowing, and loss of appetite over the past 3 months.

The medical plan of care involves chemotherapy and radiation therapy. He will need a tracheostomy prior to beginning therapies.

Objective data:

  • He smokes 1 pack of cigarettes per day.
  • His weight has decreased from 200 pounds to 180 pounds over the past 3 months.
  • The results of a CT scan and MRI reveal that this patient has throat cancer.

Subjective data:

  • The doctor said I would have a tracheostomy, but I don’t really know what that means for me. I don’t know how I am going to manage my farm if I have to have surgery.

The nursing diagnosis you must address is knowledge deficit related to lack of information regarding care of a tracheostomy as evidenced by patient’s verbal response.

Patient 2:

Ms. Flora Vack, a 25 year old female, is a bull rider in the “Riding Stars Rodeo” that is currently performing at the Civic Center. She was thrown from a bull in last night’s performance and received repeated kicks to her left posterior chest. She was seen in the emergency room and admitted for follow up care.

Her chest X-ray reveals a large pleura effusion on the left. You are assigned to prepare the patient for a thoracentesis.

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