Respiratory Labs and Diagnostic Testing Flashcards
What is Oximetery?
The amount of hemoglobin that is carrying oxygen
What percentage is a normal pulse oximetry reading?
Greater than or equal to 95%
What are causes of a decreased pulse oximetry reading?
hypoventilation
atelectasis
pneumothorax
or other lung problems
Where can pulse oximetry probes be placed?
ear lobes
fingers
toes
what is the purpose of pulse oximetry monitoring in the inpatient setting?
to titrate O2 levels
can be used continuously or intermittently
What types of laboratory testing can be done on sputum samples
culture and gram stain
cytology
AFB ( Acid-Fast Bacillus)
What types of radiology studies may be ordered for a patient with lung problems?
CXR
CT
MRI
PET Scan
What does expectorate mean?
Coughing up sputum
True or False: A sputum sample can be collected by a patient spitting saliva in a cup?
False: Sputum is expectorated from the lungs not saliva from the mouth or throat
What disease process does an AFB culture test for?
Active Tuberculosis
What type of cells does a sputum cytology culture look for?
Cancer Cells
How do you collect a sputum sample?
In a sterile container, sent to the lab ASAP, collected first thing in the morning, can be suctioned if patient/client unable to expectorate.
True or False: Sputum can be suctioned from the patient and sent for a culture?
True
What are the most common views ordered for a CXR
PA and Lateral
What is important to teach your patients about preparing for a CXR?
remove any metal between the neck and waist
What labs must be checked before a patient receives CT contrast?
BUN/Creatine
Why is it important to check a BUN/Creatine level before a patient receives contrast?
To ensure that their kidneys are working properly, and that their body will be able to filter the contrast out of the body as waste
What is important to teach your diabetic patients about a CT scan?
If they take metformin they must hold their medication for 48 hours after the scan and drink plenty of fluids.
Your patient asks you what they can expect during their CT scan, what do you advise them?
The CT scanner is preformed in radiology and shows cross-section images of the area. You will lay on a hard table that will move you in and out of the machine, you will hear some loud clicking noises as the machine takes images.
you will feel a warm flush over your body when the contrast is administered but it will only last a few seconds.
What type of allergy is important to assess before a patient receives contrast?
Shellfish and iodine
What is a MRI used for?
to assess lesions that are difficult to assess by CT scan, and for distinguishing vascular from nonvascular structures.
What type of imaging is preferred for images of the lung?
CT
How is MRI contrast different from CT contrast?
It is a contrast medium, it does not contain iodine and is safe for patients with an Iodine/ shellfish allergy
What symptom may some people experience in a closed MRI which may require sedation?
Claustrophobia
What is a PET scan used for?
Looks for lung disease/ cancer using a radioactive substance called a tracer
How does a PET scan differ from a CT/MRI?
CT/MRI look at a specific structure while a PET scan looks at body function
what is a bronchoscopy used for?
to visualize bronchi, obtain biopsy specimens or for the removal of secretions
what is the nursing care prior to a bronchoscopy?
to ensure the consent form is signed, that the patient has been NPO 6-12 hours prior to exam, and to give sedative to numb the patients throat
What nursing care follows a bronchoscopy?
Keeping patient NPO until gag reflex returns
Educate patient that blood tinged mucous/sputum is an expected finding
what are unexpected findings following a bronchoscopy?
hemorrhage
pneumothorax
What should you as a nurse look for if your patient is hemorrhaging after a bronchoscopy
sudden increase in HR and decreased BP
If your patient is 4 hours post bronchoscopy and they develop sudden shortness of air, what might the patient be experiencing?
pneumothorax
Lung biopsies can be done via?
Bronchoscope
transthoracic needle aspiration
open lung biopsy
video-assisted thoracic surgery (VATS)
What is a thoracentesis used for?
to obtain or removed pleural fluid
what is a pleural effusion?
collection of fluid in the pleural space that blocks good lung perfusion
What is third spacing?
the abnormal accumulation of fluid in an extracellular or extravascular space
what position should your patient be in for a thoracentesis?
Upright with their elbows on the overhead table, they are also instructed not to talk during the procedure
What does a pulmonary function test (PFT) do?
measures lung volume, capacity, rates of flow and gas exchange
how is a PFT performed?
you will ask patient to empty their lungs by gently breathing out as much air as you can, then breathe in a quick deep breath, hold for 10 seconds, and breath out as instructed. The test usually lasts for 30 min.
what is the purpose of a forced expiratory volume test? (FEV1)
to measure the maximum amount of air expired forcefully from the lungs in 1 second
What type of lung disease is a FEV1 used for?
Pulmonary obstructive disease
What is a peak flow meter used for?
Asthma
what can hand held peak flow meters show an early indication of?
Asthma Attack
