Ch. 1 & 2 Quiz Flashcards
What are the 4 indications for PFTs?
• diagnosis
• monitoring
• screening
• effects of chemicals or toxic meds
What are the 3 things PFTs measure?
• spirometry
• lung volumes & capacities
• DLCO
What is the gold standard for the diagnosis of obstructive disease?
Spirometry
What is the gold standard for restrictive disease?
Lung volumes & capacities
What does the DLCO measure?
Conductance of gas transfer from the inspired gas to the RBCs (Carbon monoxide [CO] “gas exchange”)
What are the 4 categories used to classify lung disease?
• obstructive
• restrictive
• mixed or combined
• pulmonary vascular disease
What are the 2 types of PFTs?
standard & specialized
What do standard PFTs consist of?
• spirometry
• DLCO
• lung volumes
Name 3 different specialized PFTs?
• ABG
• 6 min walk test
• exercise oximetry
Name a few things you should consider/notify the patient of when preparing for a test?
• no smoking
• no caffeine
• no large meals
• withhold meds
• no perfumes or colognes
How long should you withhold these meds?
Bronchodilators, Steroids, Maintenance drugs, Anticholinergic drugs?
Bronchodilators = 4-6 hrs
Steroids = never withhold
Maintenance drugs = 12 hrs
Anticholinergic = 24 hrs
What demographics should we consider for PFTs? What is the last one that is not included but we should still consider?
•Height
• Age
• Race
• Gender
weight
PFTs are _______ dependent
Effort
Tests must be ________ and ________
Acceptable ; replicable
Name 3 reasons a test may be invalid?
Coughing
Pain
Poor pt effort
To get valid results pt must be ________
Coached
What are some things you should do when you get invalid test results?
• re- instruct
• re demonstrate
• re encourage
• ask another therapist
• try again
You must get ______ replicable tests in a maximum of ______ attempts
3 ; 8
What are the 2 types of vitals capacity?
SVC & FVC
What does SVC measure?
Total volume of air that can be exhaled after a maximum inspiration (relaxed)
What does FVC measure?
Total volume of air that can be exhaled out of the lungs after a maximum inhalation (blast it out! Forced)
What is the most widely used test in PFTs?
FVC
What circumstances would you see the SVC smaller than the the FVC? What does this indicate?
Never ; poor or effort
What circumstance would you see the FVC larger than the SVC?
Air trapping
What does the FEV1 measure? What is it measured during?
Amount of air measured in 1 sec? The FVC
How much air should you be able to blow out in the FEV1? If the pt blows out less what does that tell you?
75% ; severity
What does the FEV1/FVC ratio define?
If there is an obstruction
What does the FEV1 define?
The severity of obstruction (or restriction)
What percentage indicates obstruction of the FEV1/FVC is less than?
75%
FVC is used for _______?
Validation
If the FVC is normal or higher than_____% you have an _______ only.
80 ; obstruction
If the FVC is less than ______ % you may have an ________ ________ as well or a ________ ________.
80 ; restrictive component ; mixed effect
FEV1 less than or equal too ___% to determine _______.
80 ; severity
Put these in order from most important to less important for interpretation of PFTs? (FVC, FEV1, FEV1/FVC ratio)
2.FVC
1.FEV1/FVC ratio
3.FEV1
What are the percentage value ranges for the classification of the severity measurements of FEV1
Mild = 70 to 79%
Moderate = 60 to 69%
Moderately severe = 50 to 59%
Severe = 35 to 49%
Very severe < 35%
What type of flow volume loop is this?
Normal flow loop
What type of flow volume loop is this?
Air trapping
What type of flow volume loop is this?
Obstructed upper airway
What type of low volume loop is this?
Small volume in, small volume out
FEF 25 - 75% is measured during the ______ and after _______ .
FVC ; peak expiratory flow
FEF 25 to 75% measures flow at which percentages?
• 25%
• 75 %
Which test is the most accurate measure to determine patient effort?
FEF 50%
Three test should be within _______ % of the FVC to meet criteria?
5
Peak flow is defined as?
Maximal inspiration followed by maximal expiration
What are the demographics we should consider for peak flow
Height
Age
Gender
What patient population uses peak flow a lot
Asthma patients
How many times/breaths should you do daily for peak flow? How long should you record results for?
3 times/breaths ; 2 weeks
Describe the different zones for peak flow?
Green zone = all symptoms go symptom-free and managing adequately
Yellow zone = caution symptoms worsening contact your position
Red zone = danger! notify your physician or go
What are the percentages for the three zones?
Green = 80 to 100%
Yellow = 50 to 79%
Red <50 %
The MVV is maximum _______ and full _______ .
Inspiration ; expiration
During the MVV, the patient will have what type of breathing?
Rapid, forced breathing
During the MVV the patient is breathing ____ to _____ bpm and the test must last ____ to _____ seconds long.
90-100 ; 12-15
What are the three things that the MVV measures?
Resistance
Lung compliance
Respiratory muscle strength
What are the pre-and post-bronchodilator studies used to determine?
Reversibility of airway obstruction
What is the most commonly used drug in pre-post a bronchidilators studies?
Albuterol
Why do we use a high dose of albuterol in the pre-and post bronchodilator studies?
Albuterol has a rapid onset time
You should stop an albuterol treatment if your patients heart rate increases by how much?
25 bpm
T or F Levelalbuterol or Atrovent may be used in place of albuterol if the patient cannot/will not tolerate the increase in heart rate because these drugs do not have the effect?
True
The FVC or FEV1 should increase by how much to indicate if the response to bronchodilator treatment is significant?
12% or more
How far away from the mouth should a patient hold an MDI?
1 inch
How long should a patient wait between breaths? Why?
30 seconds to one minute; time to observe any adverse reactions and give medication time to activate
How long should the inspiratory hold last after inhaling the medication from an MDI?
5 to 10 seconds
If an MDI or DPI contain steroids, what must the patient do? Why?
Rinse their mouth; failure to rinse can cause oral thrush
