Diagnostic Studies LRT

Question 1

WBC

Answer 1

• 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

Question 2

Hemoglobin

Answer 2

• transports O2 as oxyhemoglobin
• Reflects amount Hb available for combination with O2
• Male: 13.5-18g/dl Female: 12-16g/dl

Question 3

Hematocrit

Answer 3

• ratio of RBC’s to plasma
• increased hct(polycythemia) seen in chronic hypoxia
• Male:40-54% Female:38-47%

Question 4

Cl ¯

Answer 4

-decreased in COPD, (CO2 ↑)

Question 5

K

Answer 5

-(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

Question 6

ABG’s
CO2↑:
O2↓:

Answer 6

• 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

Question 7

Pulse Ox

Factors affecting:

Answer 7

• noninvasive, measures arterial blood O2 saturation

- Factors: hemoglobin, circulation, activity

Question 8

Culture and Sensitivity (C&S)

Answer 8

• Single sputum spcimen collected in sterile container to diagnose bacterial infection, select antibiotic & evaluate treatment
• AM sputum!!!

Question 9

Gram Stain

Answer 9

-staining permits classification of bacteria + or -

Question 10

Acid-fast smear & culture (AFB)

Answer 10

-acid fast bacillus; collect for acid-fast bacilli (TB); series of 3 early AM specimens

Question 11

Cytology

Answer 11

-Determines presence of abnormal cells (malignancy)

Question 12

Chest X-ray

Answer 12

-screen, diagnose and evaluate change

Question 13

CT (compute tomography)

Answer 13

-Diagnose difficult to find lesions on x-ray

Question 14

MRI (magnetic resonance imaging)

Answer 14

-Lesions difficult to assess by CT.

Question 15

Ventilation/Perfusion Scan (VQ scan)

Answer 15

• Identify areas of lung not receiving airflow(ventilation) or blood flow(perfusion)
• Used to diagnose pleural effusion

Question 16

Pulmonary Angiography

Answer 16

• Visualize pulmonary vasculature, locate obstruction, or pathological conditions
• Contrast medium injected into pulmonary artery or R side of heart

Question 17

PET(positron emission tomography)

Answer 17

• distinguish between benign/malignant lung nodules by IV injection of radioisotope
• Malignant cells have increase uptake of glucose

Question 18

Bronchoscopy

Answer 18

• 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!!

Question 19

Lung biopsy

Answer 19

• specimens obtained transbronchial or open lung biopsy

- done when pulmonary diseases cannot be dx by other procedures

Question 20

Thoracentesis

Answer 20

-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

Question 21

Pulmonary Function Test (PFT)

Answer 21

-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

Question 22

Carbon Monoxide Diffusing Capacity

Answer 22

• 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

Question 23

Exhaled Breath

Answer 23

Measurement of nitric oxide in exhaled breath, can diagnose COPD & monitor treatment

Question 24

Mediastinoscopy

Answer 24

Scope inserted thru small incision in suprasternal notch & advanced into mediastinum to inspect & biopsy lymph nodes