DIAGNOSTIC TEST and NURSING PROCEDURES

determine structural and functional abnormalities in the respiratory system

bronchography

is an angiogram of the blood vessels of the lungs

pulmonary angiogram

are measured to determine oxygenation status and acidbase balance.

Arterial Blood Gas

Test reflects amount of hemoglobin available for combination with O2. Venous blood is used.

Hemoglobin

13.2-17.3 g/dL (132-173 g/L)

male normal hgb levels

11.7-16.0 g/dL (117-160 g/L)

female normal hgb levels

Test reflects ratio of red blood cells to plasma. Increased hematocrit (polycythemia) found in chronic hypoxemia.

hematocrit

39%-50% (0.39-0.50)

male normal hct levels

35%-47% (0.35-0.47)

female normal hct levels

is obtained through puncture of radial or femoral artery or through arterial catheter.

Arterial blood gases (ABGs)

Monitors arterial or venous O2 saturation.

oximetry or CO2 monitoring

Assesses the level of CO2 in exhaled air. Graphically displays partial pressure of CO2

capnography

Performed to assess acid-base balance, ventilation status, need for O2 therapy, change in O2 therapy, or change in ventilator settings.

Arterial blood gases (ABGs)

Probe attaches to finger, toe, earlobe, bridge of the nose for SpO2 monitoring (see eFig. 26-2) or is contained in a pulmonary artery catheter for SvO2 monitoring

oximetry

Purpose is to diagnose bacterial infection, select antibiotic, and evaluate treatment.

sputum culture and sensitivity

is used for intermittent or continuous monitoring and exercise testing.

oximetry

Can be used as a diagnostic measure to detect lung disease and for monitoring patients.

capnography

is collected in a sterile container. Takes 48-72 hr for results.

sputum specimen

Staining of sputum permits classification of bacteria into gram-negative and gram-positive types

gram stain

Assesses sputum for acid-fast bacilli

Acid-fast smear and culture

Determines presence of abnormal cells that may indicate malignant condition

cytology/sputum cytology

is used when pulmonary disease cannot be diagnosed by other procedures

Open lung biopsy

7.35-7.45

normal pH level

Used to screen, diagnose, and evaluate changes in respiratory system.

Chest x-ray

Performed for diagnosis of lesions difficult to assess by conventional x-ray studies.

Computed tomography (CT) or CT scan

80-100 mm Hg

PaO2

Used for diagnosis of lesions difficult to assess by CT scan and for distinguishing vascular from nonvascular structures.

Magnetic resonance imaging (MRI)

Most common views are anteroposterior (AP) and lateral.

Chest x-ray

>95%

SaO2

Used to diagnose lung cancer, non-Hodgkin's lymphoma, granulomatous infections, and sarcoidosis.

Mediastinoscopy

It may also be done to suction mucous plugs, lavage the lungs, or remove foreign objects.

Bronchoscopy

Flexible fiberoptic scope is used for diagnosis, biopsy, specimen collection, or assessment of changes

Bronchoscopy

used to diagnose a pulmonary embolism.

spiral CT

Specimens may be obtained by transbronchial or percutaneous biopsy or via transthoracic needle aspiration (TTNA), video-assisted thoracoscopic surgery (VATS)

Lung Biopsy

Used to visualize pulmonary vasculature and locate obstruction or pathologic conditions

Pulmonary angiogram

Used to obtain specimen of pleural fluid for diagnosis, to remove pleural fluid, or to instill medication

Thoracentesis

Involves use of spirometer to assess air movement as patient performs prescribed respiratory maneuvers

Pulmonary Function Tests

Used in diagnosis and in determining exercise capacity. A complete test involves walking on a treadmill while expired O2 and CO2, respiratory rate, heart rate, and heart rhythm are monitored.

Exercise Testing

Used to evaluate lung function.

Pulmonary Function Tests

Used to measure functional capacity and response to treatment in patients with heart or lung disease.

6-Min walk test

Scope is inserted through a small incision in the suprasternal notch and advanced into the mediastinum to inspect and biopsy lymph nodes.

Mediastinoscopy

35-45 mm Hg

PaCO2

22-26 mEq/L (mmol/L)

HCO3

permits ABG sampling without repeated arterial punctures.

arterial catheter

Arterial oxygen saturation can be monitored noninvasively and continuously using a pulse oximetry probe on the finger, toe, ear, or bridge of the nose

oximetry

is particularly valuable in intensive care and perioperative situations, in which sedation or decreased consciousness might mask hypoxia

pulse oximetry

is also used during exercise testing and when adjusting flow rates during long-term oxygen therapy.

oximetry

can also be used to monitor SvO2 via a PA catheter.

oximetry

can be monitored using transcutaneous CO2 (PTCCO2) and end-tidal CO2 (PETCO2) (capnography).

Carbon Dioxide Monitoring

2 is the noninvasive measurement of alveolar CO2 at the end of exhalation when CO2 concentration is at its peak.

PETCO2

is usually presented as a graph of expiratory CO2 plotted against time.

capnography

was used mainly intraoperatively, postoperatively, and in critical care units.

capnography

assesses for hypoventilation.

CO2 monitoring

are portable and practical for use on inpatient units and emergency departments.

capnography

is a receptor that responds to a change in the chemical composition (PaCO2 and pH) of the fluid around it.

chemoreceptor

are located in the medulla and respond to changes in the hydrogen ion (H+ ) concentration.

Central chemoreceptors

An increase in the H+ concentration

acidosis

A decrease in H+ concentration

alkalosis

are located in the carotid bodies at the bifurcation of the common carotid arteries and in the aortic bodies above and below the aortic arch.

Peripheral chemoreceptors

are located in the lungs, upper airways, chest wall, and diaphragm.

Mechanical receptors

As the lungs inflate, pulmonary stretch receptors activate the inspiratory center to inhibit further lung expansion.

Hering-Breuer reflex

asthma

Watery Mucoidal

lung abscess

Foul Smelling

emphysema

thick sputum

mucopurulent

early tb sputum

hemoptisis

late tb sputum

is an analysis of cells found in mucus produced by the lungs

sputum cytology test

used for identification of acid fast bacilli the bacterium that causes tuberculosis and other illnesses.

acid fast bacilli test

also known as chest radiography

chest x-ray

also known as computed tomography scan, it is a medical imaging technique used to obtain detailed internal images of the body

CT scan

creates detailed images of the organs and tissues within the body by using a powerful magnetic field and radio waves.

MRI

It can also use to help diagnose tumors, investigate internal bleeding, or check for other internal injuries or damage

CT scan

is a type of medical imaging that shows a continuous X-ray image on a monitor, much like an X-ray movie.

fluroscopy

Is a radiographic (x-ray) examination of the interior passageways of the respiratory tract.

bronchography

Flexible fiberoptic scope is used for diagnosis, biopsy, specimen collection, or assessment of changes

bronchoscopy

It may also be done to suction mucus plugs or remove foreign objects.

bronchoscopy

A procedure to examine tissues, masses, or lymph nodes in the area behind the breastbone (sternum) and between the lungs, called the Mediastinum.

mediastinoscopy

To determine how severe lung or other cancers have spreaded and advanced.

mediastinoscopy

a radiograph of the bronchial tree following radiopaque substance injection.

bronchogram

It has the capacity to precisely localize lesions, recognize mucus plugging, sixth-order bronchial anomalies, and specific areas of air trapping brought on by small airway illness.

bronchogram

is an imaging procedure that looks at your lungs and can identify some lung issues.

lung scan

It used to determine which allergens in particular are generating the symptoms of allergies

skin testing

a procedure in which samples of lung tissue are removed to determine if lung disease or cancer is present.

lung biopsy

It is a procedure to remove fluid from the space between the lungs and the chest wall called the pleural space

thoracentesis

It measure how well the lungs works, how well the lungs take in and exhale air, and how efficiently they transfer oxygen into the blood

pulmonary function test

Airflow measurement is administered by trained personnel using a spirometer

pulmonary function test