NCLEX RN Practice Question # 397

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Laryngoscopy and bronchoscopy

1. Description:

Direct visual examination of the larynx, trachea, and bronchi with a fiberoptic bronchoscope

2. Preprocedure

• Obtain informed consent.
• Maintain NPO status for the client from midnight before the procedure.
• Obtain vital signs.
• Assess the results of coagulation studies.
• Remove dentures and eyeglasses.
• Prepare suction equipment.
• Establish an intravenous (IV) access as necessary and administer medication for sedation as prescribed.
• Have emergency resuscitation equipment readily available.

3. Postprocedure

• Monitor vital signs.
• Maintain the client in a semi-Fowler’s position.
• Assess for the return of the gag reflex.
• Maintain NPO status until the gag reflex returns.
• Have an emesis basin readily available for the client to expectorate sputum.
• Monitor for bloody sputum.
• Monitor respiratory status, particularly if sedation has been administered.
• Monitor for complications, such as bronchospasm or bronchial perforation, indicated by facial or neck crepitus, dysrhythmias, hemorrhage, hypoxemia, and pneumothorax.
• Notify the physician if fever, difficulty in breathing, or other signs of complications occur following the procedure.