Diagnostic Studies LRT Flashcards
WBC
- 5-11, dx of infections, allergies, inflammation; distinguish between acute and chronic, bacterial/viral,
- Acute: mainly neutrophils, eosinophils, and basopils
- Chronic: slight ↑ WBC, mainly monocytes, lymphos
Hemoglobin
- transports O2 as oxyhemoglobin
- Reflects amount Hb available for combination with O2
- Male: 13.5-18g/dl Female: 12-16g/dl
Hematocrit
- ratio of RBC’s to plasma
- increased hct(polycythemia) seen in chronic hypoxia
- Male:40-54% Female:38-47%
Cl ¯
-decreased in COPD, (CO2 ↑)
K
-(serum) but total body K may be decreased in acidosis (COPD) chemical buffer system moves K out of cells and H+ ions (acids) into cells to decrease extracellular acids
ABG’s
CO2↑:
O2↓:
- Assess acid/base balance, oxygenation, ventilation status.
- CO2↑:drowsy, headache, confusion, ↑BP, shallow respirations, dizziness, irregular HR, coma
- O2↓: confusion, agitation, ↑ HR RR, disorientation, delirium, dyspnea
Pulse Ox
Factors affecting:
- noninvasive, measures arterial blood O2 saturation
- Factors: hemoglobin, circulation, activity
Culture and Sensitivity (C&S)
- Single sputum spcimen collected in sterile container to diagnose bacterial infection, select antibiotic & evaluate treatment
- AM sputum!!!
Gram Stain
-staining permits classification of bacteria + or -
Acid-fast smear & culture (AFB)
-acid fast bacillus; collect for acid-fast bacilli (TB); series of 3 early AM specimens
Cytology
-Determines presence of abnormal cells (malignancy)
Chest X-ray
-screen, diagnose and evaluate change
CT (compute tomography)
-Diagnose difficult to find lesions on x-ray
MRI (magnetic resonance imaging)
-Lesions difficult to assess by CT.
Ventilation/Perfusion Scan (VQ scan)
- Identify areas of lung not receiving airflow(ventilation) or blood flow(perfusion)
- Used to diagnose pleural effusion
Pulmonary Angiography
- Visualize pulmonary vasculature, locate obstruction, or pathological conditions
- Contrast medium injected into pulmonary artery or R side of heart
PET(positron emission tomography)
- distinguish between benign/malignant lung nodules by IV injection of radioisotope
- Malignant cells have increase uptake of glucose
Bronchoscopy
- BRONCHI ARE VISUALIZED THRU A FIBEROPTIC TUBE
- Used to obtain biospy specimens, assess changes from treatment & remove mucous plugs
- NPO UNTIL GAG REFLEX RETURNS AFTER TEST!!
Lung biopsy
- specimens obtained transbronchial or open lung biopsy
- done when pulmonary diseases cannot be dx by other procedures
Thoracentesis
-Insertion of needle thru chest wall into pleural space to obtain specimens for diagnostic evaluation, remove pleural fluid & instill medication into the pleural space
-Position: sitting upright. pt must be still during procedure
Chest X-ray after to check for pneumothorax
Pulmonary Function Test (PFT)
-Normal tidal volume:500ml
-Assess functional ability of lungs, measures lung volumes & airflow
MEASURES VITAL CAPACITY;norm: 80-120%
-Pt deep breathes via spirometer & exhales as long as possible
Carbon Monoxide Diffusing Capacity
- Measures effectiveness of gas exchange, pt inhales carbon monoxide, helium, O2 holds breath 10 secs.
- Results differentiate between COPD and dx of chronic bronchitis & asthma
Exhaled Breath
Measurement of nitric oxide in exhaled breath, can diagnose COPD & monitor treatment
Mediastinoscopy
Scope inserted thru small incision in suprasternal notch & advanced into mediastinum to inspect & biopsy lymph nodes
