NCLEX-PN

In-Depth Procedures: Meeting the Challenge For specific procedures, such as intubation , the MSMAID mnemonic serves as a guide: ●​ M: Set up Monitors (blood pressure, pulse oximetry, ECG, telemetry). ●​ S: Prepare Suctioning equipment.

●​ M: Ensure availability of Machines (mechanical ventilator). ●​ A: Assemble Airway supplies (laryngoscope, artificial airways). ●​ I: Secure Intravenous supplies and access. ●​ D: Organize Drugs for emergencies and anesthesia. For diagnostic bronchoscopies , follow these procedure-specific guidelines, in addition to the general ones. Those with an asterisk ( * ) are generally done by a physician: ●​ Maintain client NPO status for at least 6 hours when possible. ●​ Administer atropine to reduce respiratory secretions. ●​ Use moderate conscious sedation or general anesthesia. ●​ Apply nebulized lidocaine to numb the pharynx and vocal cords. * ●​ Lubricate the bronchoscope. * ●​ Insert the bronchoscope into the bronchi. * For needle biopsies: ●​ Position the client appropriately. ●​ Prep the site with betadine. * ●​ Cover the area with a sterile fenestrated drape. * ●​ Administer topical local lidocaine if ordered. * ●​ Administer local anesthetic. * ●​ Collect the specimen. * ●​ Label and transport the specimen to the lab. ●​ Apply a sterile dressing. For thoracenteses : ●​ Position the client for fluid withdrawal. ●​ Prep the site with betadine. * ●​ Cover the area with a sterile fenestrated drape. * ●​ Administer topical local lidocaine if ordered. * ●​ Administer local anesthetic. * ●​ Withdraw fluid using a needle and syringe. *

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