respiratory and cardiac diagnostic tests Flashcards
arterial blood gas (ABG)
conditions: PE
performed if pt is in respiratory distress
if a pt has a PE the ABG will show hypoxemia (PaO2 < 80) and respiratory alkalosis (PaCO2 < 35) due to the pt’s increased RR
CBC
checks oxygenation and platelets for bleeding and clotting
D-Dimer
checks for presence of a clot in the body
increased D-Dimer = clot
negative D-Dimer = no clot
Mantoux skin/serum IGRA
assesses for TB exposure/infection
sputum culture
checks for bacteria i.e. respiratory infections
biopsy
diagnoses lung cancer etc
pulse oximetry
used to monitor oxygenation
95-100% is normal but pts with chronic respiratory issues may have lower baslines
chest x-ray for respiratory issues
rules out other causes of respiratory distress
may show an underlying pathology like pneumonia or pneumothorax that can explain the symptoms
CT scan/spiral CT scan
spiral CT scan: identifies PEs
MRI
if contrast is being used: check kidney function (BUN and creatinine), give fluids after, ask about shellfish allergy
screen for metal: implant, pacemaker, metal plates, screws
x-rays can show metal if unsure
ventilation/perfusion (V/Q) scan
used if a CT scan isn’t available
identifies the areas of the lungs that are ventilated but are not perfusing effectively
less specific and takes longer than a CT scan
PET scan
Done when they suspect cancer
Full body scan
Contrast material with glucose is injected
For diabetics: more insulin and frequent BS checks
pulmonary function studies / peak flow
peak flow: asthma; measures how well they’re expiring air; portable device they blow into
pulm function: determine how much air the lungs can hold; gives an idea of the status of lungs especially in pts with chronic lung disease
bronchoscopy
allows for direct visualization of the respiratory tract
NPO for 8 hours before the procedure
thoracentesis
excess fluid is removed from the pleural space
after the procedure: vital signs, respiratory assessment, lung sounds
assess for s/s pneumothorax
encourage pt to cough and deep breathe following the procedure
assess area for drainage and bleeding; a minimal amount of blood is normal
creatinine kinase (ck-mb)
used to diagnose MIs
not preferred over troponin due to short testing window
troponin
released after myocardial cell death
the higher the troponin, the greater the damage
levels detectable for 10-14 days
3 troponins are drawn to diagnose an MI
high sensitivity troponin
more precise
identifies low-risk pts eligible for early discharge
drawn upon admission and one hour later
homocysteine
byproduct of protein metabolism
when levels are elevated, blood clotting may increase
treat with folic acid/B vitamin complex
c-reactive protein (hs-crp)
reflective of inflammation of coronary arteries
treatment: aspirin, stop smoking, exercise, lipid lowering agents
serum lipids
triglycerides: < 150
HDL: 40-60
LDL: < 100
total cholesterol: < 200
ankle-brachial index (ABI)
condition: peripheral vascular disease
BP measurement in arm and leg
tells you how well that extremity is being perfused
holter monitoring
recording of EKG rhythm for 24-48 hours
instruct pt to keep a log of what they are doing
echocardiogram
diagnostic test for HF
ultrasound of heart
can measure heart structures and size, blood flow, and ejection fraction
ejection fraction
% of blood volume ejected during systole
should be > 50%
transesophageal echocardiography (TEE)
used if they need to look at the structure behind the heart
goes in through the esophagus
not for pts with esophageal disorders like reflux
check gag reflex!!!!!! no eating or drinking until gag reflex returns
exercise stress test
involves walking on a treadmill
ECG and BP recording before, during, and after exercise
pts should report any chest pain or SOB during the test
stress ECHO
same as exercise stress test but includes echo ultrasound before and immediately after exercise
pt needs to get back on table as soon as exercise stops so images can be obtained
chemical stress test
used if pt cannot walk on treadmill
studies involve injection of isotopes
scans are repeated before and after exercise for comparison
chest x-ray for cardiovascular issues
general screening for size, shape, and position of the heart
not diagnostic but can show concerns like hypertrophy or pulmonary congestion
coronary calcium scan
CT of heart
checks plaque formation in the coronary arteries
no smoking or caffeine 4 hours before the test
cardiac catheterization
dye is injected into the coronary arteries to evaluate condition/blood flow
preop: iv access, NPO 6-8 hours, check liver function, baseline assessments ESP pulses, sedation to relax pt
intra-op: warn pt about flushing feeling; monitor cardiac status
post-op: pt lies flat for 2-6 hours; check site for bleeding; hydration; frequent vital signs; check pulses q15 mins
