respiratory labs and diseases

Question 1

results

Answer 1

blood: vein, FS, artery (usually RT)
urine, stool, sputum, other
xray and scans

Question 2

O2 monitoring: oximetry

Answer 2

amount of hemoglobin carrying O2
>95 is normal
low = hypovent, atelectasis, pneumothorax, other lung issues
noninvasive: intermittent v continuous
titrate O2 levels
no nail polish, toe, earlobe

Question 3

sputum

Answer 3

not saliva!, sterile container, morning is best (no food or drink and sedentary secretions), may need to suction, send asap
c+s
cytology: cancer
AFB: TB

Question 4

radiology: CXR

Answer 4

remove metal btw waist and neck (bra strap, necklace), posterior-anterior and lateral (barrel chest), 2D

Question 5

radiology: CT scan

Answer 5

shows cross section, may require sedations r/t need to lie still (claustrophobic), hard table, scanner revolves around body, make clicking noises (tell before), with or without contrast (hcp pref, highlight structure, iodine allergy)
with contrast: assess BUN/cre (let hcp know if elevated, for renal function), allergy to shellfish (iodine), feel warm flush, force fluids after

Question 6

radiology: MRI

Answer 6

for lesions difficult to assess by CT (lung apex), and to distinguish vascular from non vascular
otherwise - use CT
uses contracts medium - not iodine based, closed (may need sedation - claustrophobic), remove anything metal

Question 7

radiology: PET

Answer 7

use radioactive tracer to look for cancer /lung disease
function! not structure -> blood flow, use of O2, uptake of sugar

Question 8

TB skin test

Answer 8

ID injection -> 10-15 degrees, bleb, top of epidermis under skin)

Question 9

bronchoscopy

Answer 9

visualize bronchi, biopsy specimen, for treatment (remove secretions)
naso or oropharynx is anesthetized - big scope

Question 10

bronchoscopy: nc before

Answer 10

consent (invasive), NPO 6-12 hr before (n and asp), sedative (big tube)

Question 11

bronchoscopy: nc after

Answer 11

keep NPO until gag reflex (numb - no drink either), blood tinged mucus normal
biopsy -> hemorrhage (unexplained HR increase, BP drop) or pneumothorax monitor (abrupt SOA, lung collapse)

Question 12

lung biopsy

Answer 12

bronchoscope -> endoscopy suite (- scopy = scoping orifice)
transthoracic needle aspiration = done with CT guidance in radiology
open lung biopsy = in OR
video assisted thoracic sx/VATS = done in OR

Question 13

thoracentesis

Answer 13

pleural effussion (fluid in pleural space (gray on xray) - 3rd spacing = no purpose; decreased SA in lungs, resp issues, sometimes resolves on own)
-tesis = tapping an area
large bore needle into pleural space = for fluid diagnosis, remove fluids, instill meds

Question 14

thoracentesis: nc before

Answer 14

consent, pt upright with elbows on overhead table in room, dont talk

Question 15

thoracentesis: nc after

Answer 15

CXR per order, hypoxia and or pneumothorax
cxr to make sure its not a pneumothorax

Question 16

pulmonary function test

Answer 16

measure lung function with respect to time (s)
nose punched, lung volumes (biggest peak and fall)
FEVI: deep breath and then max air forcefully expired in 1s; lower in pt with OPD
peak flow meter: asthma