From Textbook (Treatment Vocabulary) - Unit 8: The Respiratory System

auscultation and percussion

Procedure that uses a stethoscope to listen to breath sounds (see Figures 2-20 and 4-21). Percussion uses the finger of one hand to tap over the finger of the other hand that is spread across the patient's back over a lobe of the lung (see Figure 2-21). After a few taps, the hand is moved over another lobe. The sound tells the physician if the lung is clear or if there is fluid or a tumor present.

cardiopulmonary resuscitation (CPR)

Procedure to ventilate the lungs and circulate the blood if the patient has stopped breathing and the heart has stopped beating. In the past, mouth-to-mouth resuscitation involved forcing air into the patient's lungs; chest compressions pumped blood through the heart. In 2010, the American Heart Association changed its CPR guidelines to require only chest compressions because there is already enough oxygen in the blood and so just circulating the blood is all that is needed.

endotracheal intubation

Procedure in which an endotracheal tube (ETT) is inserted. A lighted laryngoscope helps visualize the vocal cords. The tube goes through the oral cavity and pharynx, between the vocal cords of the larynx, and into the trachea. This establishes an airway for a patient who is not breathing or needs a ventilator (see Figure 4-19 🟥). This procedure is performed by paramedics in an ambulance, by physicians in the emergency department, or by anesthesiologists in the operating room prior to surgical procedures. Alternatively, a nasotracheal tube can be inserted through the nasopharynx to reach the trachea.

Heimlich maneuver

Procedure to assist a choking victim with an airway obstruction. The rescuer stands behind the victim and places a fist on the victim's abdominal wall just below the diaphragm and, with both hands, gives a sudden push inward and upward. This generates an exhaled burst of air that pushes the obstruction into the mouth where it can be expelled.

incentive spirometry

Medical device to encourage patients to breathe deeply to prevent atelectasis. A spirometer is a portable plastic device with a mouthpiece. It contains balls that move, a visible incentive to the patient to inhale forcefully.

oxygen therapy

Procedure to provide additional oxygen to patients with pulmonary disease. Room air is 21% oxygen. A patient can need amounts of oxygen ranging from 22% to 100%. Oxygen is delivered to the patient via a nasal cannula (see Figure 4-20 🟥) or a face mask. An infant can receive oxygen through a rigid plastic hood placed over the head or in an oxygen tent. Oxygen is drying, and so patients who need a high flow of oxygen or prolonged oxygen therapy receive humidified oxygen (bubbled through water). A patient who requires respiratory assistance as well as oxygen is placed on a ventilator (respirator), a mechanical device that breathes for the patient or assists with some breaths. Ventilators can provide up to 100% oxygen, as well as pressure to keep the alveoli from collapsing. An Ambu bag is a hand-held device that is used to manually breathe for the patient on a temporary basis. It is attached to a face mask or to an endotracheal tube and is squeezed to force air into the lungs (see Figure 4-21 🟥). The patient is said to be being “bagged.”

vital signs

Procedure during a physical examination in which the temperature, pulse, respirations (TPR), and blood pressure (BP) are measured. The respirations are measured for 1 minute by counting each rise and fall of the chest as one breath. An assessment of pain is often done as well, as the fifth vital sign.

bronchoscopy

Procedure that uses a lighted bronchoscope inserted through the mouth and larynx to examine the trachea and bronchi. Attachments on the bronchoscope can remove foreign bodies, suction thick mucus, or perform a biopsy.

chest tube insertion

Procedure that inserts a plastic tube between the ribs and into the thoracic cavity to remove accumulated air, fluid, pus, or blood due to trauma or infection. The tube is connected to a container (to measure the drainage) and to a suction device. A chest tube is used to treat pneumothorax, pyothorax, or hemothorax.

lung resection

Procedure to remove part or all of a lung. A wedge resection removes a small wedge-shaped piece of lung tissue. A segmental resection removes a large piece or a segment of a lobe. A lobectomy removes an entire lobe (see Figure 4-22 🟥). A pneumonectomy removes an entire lung. A lung resection is done as a biopsy procedure or to treat severe emphysema or lung cancer.

thoracentesis

Procedure that uses a needle and a vacuum container to remove pleural fluid from the pleural space. It is used to treat a pleural effusion or obtain fluid for the diagnosis of lung cancer. It is also known as a thoracocentesis.

thoracotomy

Incision into the thoracic cavity. This is the first step of a surgical procedure involving the thoracic cavity and lungs.

tracheostomy

Procedure that begins with an incision into the trachea (tracheotomy) to create an opening. A tracheostomy tube is then inserted to keep the opening from closing (see Figure 4-23 🟥). A tracheostomy provides temporary or permanent access to the lungs in patients who need respiratory support, usually with a ventilator. The patient is said to have a “trach.”