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Cardiopulmonary Diagnostic (PFTs) > Introduction to PFT's > Flashcards

Introduction to PFT's Flashcards

1
Q

What are some indications for PFT’s (4)

A
  • Diagnosis (restrictive or obstructive)
  • Screening
  • Monitoring
  • Effects of chemical and toxic medications
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2
Q

What do PFT’s measure (3)

A
  • Spirometry (Obstructive)
  • Lung Volumes (Restrictive)
  • Diffusion Capacity of Carbon Monoxide (DLCO)
    (it determines gas exchange)
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3
Q

Spirometry is defined as

A

the flow of air in and out of the lungs

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4
Q

Spirometry is considered the ______ ___________ test for diagnosing _____________ lung diseases

A

GOLD STANDARD;
Obstructive

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5
Q

What are the 3 factors in doing a spirometry test?

A
  • Determining the severity of COPD or its progress
  • Measuring the response to bronchodilators
  • Assessing the risk of pulmonary disease
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6
Q

Lung volume is defined as the amount of air in the lungs at different

A

phases of the respiratory cycle

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7
Q

Lung volumes are most commonly used for diagnosing and assessing _____________ lung disease

A

restrictive

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8
Q

Diffusion Capacity for Carbon Monoxide is defined as a measure of the conductance of

A

gas transfer from inspired gas to RBC (gas exchange)

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9
Q

PFT’s help to classify lung disease into 1 of 4, what are they (ORMP)

A
  1. Obstructive lung disease (CBABE)
  2. Restrictive disease (ILD, Extrastital lung disease, Chest wall pathology, Neuromuscular disease)
  3. Mixed or combined Lung disease
  4. Pulmonary Vascular Disease
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10
Q

What some types of PFTs

A

standard PFT
- Spirometry (flow volume loops)
- Lung volumes and capacities
- DLCO

specialized PFT
- ABG
- 6 minute walk

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11
Q

While preparing for a test bronchodilators should not be taking

A

4 hrs prior to test, unless needed

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12
Q

How many hours before a test for maintenance meds (Symbicort, brovana, Advair)

A

12 hrs

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13
Q

Which type of drug should not be withheld prior for a test

A

Steroids (Predniosne, pulimcort)

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14
Q

Pts should not have these prior to test (4)

A
  • caffeine
  • smoking
  • large meals
  • perfumes
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15
Q

Predicted values come from a national database and are based on 4 demographics

A

HGAR
- height
- gender
- age
-race

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16
Q

PFT test are

A

effort dependent

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17
Q

PFT test must be ______________ and ______________

A

Acceptable and Replicable

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18
Q

To get valid results the pt must be

A

coached

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19
Q

_____________ the procedure and ______________ best effort

A

Explain; encourage

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20
Q

______________ the test maneuver

A

Demonstrate

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21
Q

If a test is not replicable…..

A

it is not valid

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22
Q

Reasons for an invalid test (5)

A
  • not understanding directions
  • lack of coordination
  • poor effort
  • pain
  • couging
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23
Q

What do we do if you get an invalid results (5)

A
  • Try again
  • Resinstruct the pt
  • Redemonstrate the maneuver
  • Ask another therapist to assist
  • make comments on pt’s report
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24
Q

How many replicable test do we need?

A

3

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25
Q

A pt has a maximum of how many attempts?

A

8

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26
Q

A vital capacity can be _______ or _______

A

slow or forced

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27
Q

Slow vital capacity (svc) measures the TOTAL VOLUME of air

A

exhaled out of the lungs after a maximum inhalation (relaxed)

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28
Q

Forced vital capacity (FVC) measures the

A

TOTAL VOLUME of air out of the lungs after a maximum inhalation (blast it out)

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29
Q

Which test is most widely used in PFTs?

A

Forced Vital Capacity (FVC)

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30
Q

SVC should never….

A

be smaller than FVC

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31
Q

What does it mean if SVC is smaller than FVC?

A

poor pt effort

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32
Q

What circumstances would you see the SVC larger?

A

obstruction

33
Q

SVC should only be greater than FVC during an

A

obstruction (air trapping)

34
Q

What disease process would SVC be greater than FVC (2)

A
  • Emphysema
  • Asthma
35
Q

During SVC the pt has

A

Plenty of time to get all the air out

36
Q

During FVC the pt has

A

Limited time to get the air out

37
Q

When is Forced Expiratory Volume over 1 second (FEV1) measured?

A

During the FVC

38
Q

What does FEV1/FVC ratio determine?

A

If there is an obstruction

39
Q

What does FEV1 determine?

A

the degree of the obstruction

40
Q

If FEV1/FVC ratio is < ____% predicted, what does that indicates?

A

75%;
indicates an obstruction disease (CBABE)

41
Q

FVC validation; If FVC is normal/ high (80%) you have an

A

obstruction only

42
Q

If the FVC is low <80% you may have a

A

restrictive component (mixed)

43
Q

FEV1 < 80% is used to determine the what?
List them.

A

severity;
Mild, moderate, moderately severe, severe, or very severe

44
Q

Classification of Severity of FEV1
Mild

A

70-79%

45
Q

Classification of Severity of FEV1
Moderate

A

60-69%

46
Q

Classification of Severity of FEV1
Moderately severe

A

50-59%

47
Q

Classification of Severity of FEV1
Severe

A

35-49%

48
Q

Classification of Severity of FEV1
Very Servere

A

<35%

49
Q

Forced Expiratory Flow (FEF) is measured …

A

during FVC

50
Q

FEF 25%- 75% is measured at

A

25% and 75% of the exhalation

51
Q

FEF 25%-75% reflects…

A

abnormalities in the small airways

52
Q

_______ is the most ____________ measure used to determine patient effort

A

FEF 50%;
accurate;

53
Q

Peak flow is defined as a

A

maximal inspiratory, followed by a maximal forced exhalation

54
Q

Predicted values for peak flow are based on?(3)

A
  • height
  • age
  • gender
55
Q

Asthmatics can be measured w/

A

peak flow meter or during spirometry testing

56
Q

While using peak flow what should be recorded and for how long?

A
  • The highest # breath
    (3 breaths daily)
  • 2 weeks
57
Q

What is the Green zone

A

80 to 100% relatively free of symptoms and can maintain current asthma management

58
Q

What is the yellow zone?

A

50 to 79% “caution” As asthma symptoms worsen, contact Dr to fine-tune regiment

59
Q

What is the Red zone?

A

<50% “Danger” Tx isn’t controlling your symptoms

60
Q

Maximum Voluntary Ventilation (MVV) is the

A

maximum inhalation and full exhalation; Rapid forced breathing (90 to 100 bpm) in 12 to 15 seconds

61
Q

At least ___ MVV tests should be performed and should be within ___% of each other

A

2;
20%

62
Q

During a MVV test you should report the

A

highest breath rate

63
Q

MVV also measures ___________, _____________ and _________ muscle strength

A

resistance;
compliance;
respiratory

64
Q

How do we know if the response is significant?

A

An increase in FVC of 12% or more is considered significant

65
Q

List the proper way to use an MDI

A
  • Shake the MDI (prime if needed)
  • Hold MDI slightly away from the pt’s or use a spacer (preferred method)
  • Instruct pt to begin inhaling slowly to activate the MDI
  • Have pt continue to inhale maximal inspiration
  • Instruct pt to hold the breath for 5 to 10 sec, followed by a slow exhalation
  • Repeat 1 minute in between dose
66
Q

From Quiz
What is the Gold standard PFT test considered for diagnosing Obstructive disease?

A

Spirometry

67
Q

Which standard PFT is used to diagnose Restrictive /disease

A

Lung Volumes

68
Q

What does DLCO measure?

A

Gas exchange

69
Q

What 4 demographics are used in the national data base to predict normal values?

A

HGAR
- Height
- Gender
- Age
- Race

70
Q

Test results are __________ dependent and must be __________ to get valid results

A

effort;
coached

71
Q

In order for a PFT to be valid it must be _____________ and ____________

A

acceptable;
replicated

72
Q

Explain in detail what you should do if you get invalid results

A
  • Try again
  • Resinstruct the pt
  • Redemonstrate the manuever
  • Ask another Therapist to help
  • Make comments on pt’s record
73
Q

Last question from quiz
Name 3 or more indications for PFTs

A
  • Diagnosis (restrictive or obstructive)
  • Screening (To access symptoms, the risk for lung disease, pre-op)
  • Monitoring (effectiveness of medications and therapy)
  • Effects of chemicals and toxic medications (mosaic, firefighters, meds such as Amiodarone)
74
Q

FEV1/FVC Ratio defines

A

obstruction

75
Q

FEV1 defines the

A

degree of the obstruction

76
Q

If FEV1/FVC ratio is _____ ______ ____% predicted it indictaes an ____________ disease (________)

A

less than 75%;
obstructive;
CBABE

77
Q

If the FVC is normal/high (80%) you have an…..

A

obstruction only

78
Q

If the FVC is low (<80%) you may have a….

A

restrictive component (mixed)

79
Q

FEV1 <80% to determine the severity it is

A

Mild, moderate, moderately severe, severe, or very severe

Cardiopulmonary Diagnostic (PFTs) (6 decks)

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