Chest X ray

It is the most common diagnostic procedure to find out any anatomical abnormality or infection in the lung

Nurses Responsibility

-Remove metal object or radio opaque object, light jewels.

-Access the female patient whether she is pregnant or not. If so allow only after 20th week of gestation

-Remove constructive clothing and keep loose gowns.

-Instruct the patient to take deep breath and hold it during procedure to expand lungs.


Sputum examination

-Obtain early morning specimen and it should be collected in a sterile container.

-Instruct the patient to take deep breath and cough deeply to collect sputum.

-Rinse mouth with plane water.

Do not brush the teeth with paste.

-Obtain sputum sample before starting antibiotics.

-10 to 15ml of sputum should be collected.



To view larynx, trachea, and bronchus with a fiber optic scope.

Nurses Responsibility

-NPO for 8hr.

-Take consent.

-Apply local anesthesia or spray.

– Remove denture and glasses.

POST Procedure

  • NPO until gag reflex return.
  • Monitor vital signs.
  • Small amount of blood tinged sputum is normal.
  • Turn the head to one side to prevent aspiration.


  • Bronchial perforation
  • Hemorrhage
  • Infection
  • Pneumothorax
  • cardiac arrhythmia

Pulmonary angiography

Study of pulmonary artery by introduction of die in to the pulmonary artery through the femoral or antecubital vein contract die is injected and serious of X-ray are taken.

  • Nurses Responsibility
  • Informed consent.
  • NPO
  • Access allergy to sea food and shell fish.

Post procedure

  • Insertion site care.
  • Monitor temperature.
  • Increased fluid intake.
  • If femoral vein is used keep bed rest for 8 to 12hr


Insertion of needle in to the thoracic cavity for removal of air or fluid in the plural place  

Nurses Responsibility

  • Informed consent.
  • Monitor vital signs.
  • Do coagulation study
  • Prepare the patient for X-ray or USG

Position during the procedure

Sitting up right at the edge of the bed and leaning forward on a cardiac table.

Non ambulating patient

Sidelining the affected side upward with 45degree head elevation.

Instruct the patient do not move or cough during the procedure

Post procedure

  • Insertion site care.

–     Monitor temperature

–     Pressured dressing should be applied to the side.


  • Pulmonary air embolism.


Tissue taken from the lung for histopathological study

Nurses Responsibility

  • Informed consent.
  • Monitor vital signs.
  • Do coagulation study.
  • Keep NPO.
  • Administer sedative.

Post op procedure

  • Apply pressured dressing.
  • Administer analgesic.
  • Monitor for complication


  • haemorrhage
  • pneumothorax


Ventilation means patency of the pulmonary airway. And perfusion evaluate blood supply to lung. For accessing the ventilation patient inhale a radioactive gas and serious of X-rays are taken to evaluate the perfusion. Radio isotope die is administered through vein in to the pulmonary artery and scanning is done.

Nurses Responsibility

  • Informed consent.
  • NPO
  • Access allergy to sea food and shell fish
  • Remove metallic object.

Post procedure.

  • Increase fluid intake.
  • Wear glove when in contact with urine and stool.
  • Wash hands\after each voiding.
  • Double flush the bathroom after voiding


  • Ph:                 35-7.45
  • Pco2: 35-45mm of hg
  • Po2: 80-100 mm of hg
  • Hco3: 22-29 mcq
  • O2 concentration: 90-100%


  • Do Allen test before sample collection.
  • Collect blood from artery only.
  • Insert needle in degree.
  • Keep sample over ice piece.
  • Sent sample as soon as possible
  • Apply pressure for 5 minute.


To determine oxygen concentration. Normal is 96-100%


  • Apply sensor or probe to the finger, ear lobe, nose, and forehead.
  • Keep transducer at heart level.
  • Do not keep probe in extremity with impair circulation.
  • Remove nail polish.
  • Do not keep the probed extremity under light.


Used to access lung capacity. And to maintain lung expansion.


  • Instruct the patient to sit upright and keep mouth piece tightly around mouth.
  • Inhale slowly to raise the flow rate indicator between 600-900 mark
  • Instruct the patient to hold the breath for 5 second and exhale through purse lips
  • Repeat the procedure 10 times/hours.

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