Question

1.Today you are assessing a 45 year old morbidly obese female who is a smoker and is post op laminectomy 48 hours ago. The post op notes stated that she had difficulty being extubated in the recovery room but has responded well in the last 24 hours with pulse ox at 99 % and vital signs stable at the last check 6 hours ago. She is sitting up when you enter the room but is lethargic and has a temperature of 100.4, pulse is 100, respirations are 22 and shallow. Pulse ox is 93%.
You listen to her lungs and determine that she has diminished breath sounds at the left base. What other assessment techniques would you use and why? What would you expect to find as you perform these techniques?

Answer 1

The common pulmonary complications after surgery are pneumonia, aggravation of any previous illness,constriction of bronchial walls,atelectasis

• Auscultate by telling patient to say the letter "E" in case of pneumonia it will sound as letter "A".This is a sign of fluid or air collection in the air sac
• Assess to find adventious breath sounds like wheezing, crackles occurs in case of edema of the pleura cavity
• Inspiratory and expiratory breath has to be assessed as this changes with the problems are associated with lung infection
• Chest X ray to rule out pneumonia
• ABG to assess the cause of hypoxia
• Blood test to rule out any infection as patient is having increased temperature