Spirometry and Peak Flow

Question 1

How to measure peak flow

Answer 1

To measure your peak flow:

find a comfortable position, either sitting or standing – do this the same way every time
push the pointer back to the first line of the scale nearest the mouthpiece
hold the peak flow meter so it’s horizontal and make sure that your fingers are not obstructing the measurement scale
breathe in as deeply as you can and place your lips tightly around the mouthpiece
breathe out as quickly and as hard as you can
when you’ve finished breathing out, make a note of your reading
This should be repeated 3 times, and the highest of the 3 measurements should be recorded as your peak flow score.

Question 2

How to take peak flow

Answer 2

Take your peak flow before using the preventer inhaler.
- Always use the same peak flow meter.

Question 3

What does spirometry do

Answer 3

Measures functional lung volumes.

Question 4

Causes of obstructive lung disease

Answer 4

Reversible (asthma) and irreversible (COPD). o Bronchiectasis.
o Inhaled foreign body, tumour.

Question 5

Restrictive lung disease explanation

Answer 5

Usually diseases of the interstitium affecting chest wall movement and elasticity;
o Scoliosis, kyphosis, ankylosing spondylitis.
o Neuromuscular diseases like Guillain-Barré syndrome, myasthenia gravis. o Pulmonary fibrosis, sarcoidosis, asbestosis.
- Due to restriction, lung volumes are small and most of breath is out in the first second.
o FEV1/FVC > 80% because of the FVC being proportionally lower.

Question 6

How to intro checkup

Answer 6

Check patients understanding of peak flow/spirometry and their condition –
o Peak flow test measures how fast you can breathe out so you can see how
well your lungs are working.
o Spirometry measures lung function, specifically the amount (volume) and
the speed (flow) of air that can be inhaled/exhaled.

Question 7

PC checkup

Answer 7

How are they feeling?
- Any recent illnesses/infections?
- Any SOB?
- Is there any particular time you notice your condition worsens (winter etc).
- Enquire about red flags;
o Wheeze is getting worse.
o Affecting ADL.
o Waking up at night with symptoms (SOB, cough). o Using reliever inhaler more than usual.

Question 8

DHx checkup

Answer 8

How well do you think your condition is being controlled?
- What medications do you take? Which inhalers do you use and how often?
- Do you take any other medications (if on steroids then severe).
- Any beta-blockers.
- Check inhaler technique and check inhaler use has been assessed by the nurse.

Question 9

SHx Checkup

Answer 9

Any (new) pets?
- Recent travel anywhere?
o Particularly to places that are polluted.
- Housing situation (damp)?
- Hayfever.
- Smoking? Alcohol? Impact of condition on life.

Question 10

Advice to help

Answer 10

Stop smoking.
- Avoid precipitants.
- Vaccination (flu).
- Exercise.
- Eating.
- Support.