Exam 2: Chap 8 Flashcards
Bronchoscopy
Expectoration of sputum sample/ tracheal suction
Analysis of sputum
amount, quality, color
The sputum sample may be examined for
- Culture and sensitivity 2. gram stain 3. acid fast smear and culture and 4. cytology
Culture and sensitivity study
single sputum sample is collected in a sterile container. Test is performed to diagnose bacterial infection, select an antibiotic, and evaluate the effectiveness of antibiotic therapy
Turn around time for Culture and sensitivity study
48 to 72 hours
Gram staining of sputum is performed to
to classify bacteria into gram negative organisms and gram positive organisms
Acid fast smear and culture is performed to
determine the presence of acid fast bacili (myobacterium, TB). a series of 3 early morning sputum samples is tested.
Cytology
examination entails the collection of a single sputum sample in a special container with fixative solution. Sample is evaluated under a microscope for the presence of abnormal cells that may indicate a malignant condition
Skin tests are commonly performed to evaluate
allergic reactions or exposure to tuberculous bacilli or fungi
Positive test/ negative test
patient has been exposed/ no exposure
anergy
Depression of cellmediated immunity which can show a negative test. such as which develops with (HIV)
Bronchoscope allows direct visualization of the
upper airways (nose, oral cavity, and pharynx), larynx, vocal cords, subglottic area, trachea, bronchi, lobar bronchi, segmental bronchi down to the third or fourth generation
Yellow sputum correlation
acute infection
Green sputum correlation
Associated with old, retained secretions, green and foul smelling secretions are freq found in pts with anaerobic or pseudomonas infection, such as bronchiectasis, CF, and lung abscess
Thick, stringy, and white or mucoid sputum correlation
Bronchial asthma
brown sputum correlation
Presence of old blood
Red sputum correlation
fresh blood
A diagnostic bronchoscopy is usually performed when an
infectious disease is suspected and not otherwise diagnosed or to obtain a lung biopsy sample when the abnormal lung tissue is located or near the bronchi
Bronchoscopy is indicated for a number of clinical conditions, including further inspection and assessment of
- abnormal radiographic findings 2. persistent atelectasis 3. excessive bronchial secretions 4. acute smoke inhalation injuries 5. intubation damage 6. bronchiectasis 7. foreign bodies 8. hemoptysis 9. lung abscess 10. major thoracic trauma 11. stridor or localized wheezing and 12. unexplained cough
Bronchoalveolar lavage (BAL)
A common diagnostic bronchoscopic technique. Involves injecting a small amount (30mL) of sterile saline through the bronchoscope and then withdrawing the fluid for examination of cells
Therapeutic Bronchoscopy includes
- suctioning of excessive secretions or mucous plugs, especially when lung atelectasis is present or forming 2. the removal of foreign bodies or cancer obstructing the airway 3. selective lavage and 4. management of life threatening hemoptysis
First line of defense in the treatment of atelectasis from retained secretions
Respiratory therapy modalities at the pts bedside (CPT, intermittent percussive vent, postural drainage, deep breathing and coughing tech, and PEP therapy)
Endobronchial unltrasound (EBUS) examination
may be performed during a bronchoscopy to help establish the stage of lung cancer and, importantly, establish if- and how- the cancer may have spread
EBUS can provide an accurate
staging of lung cancer and can help reduce the amount of tissue that needs to be removed during surgery without invasive procedures