Ch. 1 & 2 Quiz Flashcards by Joy Obilor-Okereafor

What are the 4 indications for PFTs?

• diagnosis
• monitoring
• screening
• effects of chemicals or toxic meds

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What are the 3 things PFTs measure?

• spirometry
• lung volumes & capacities
• DLCO

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What is the gold standard for the diagnosis of obstructive disease?

Spirometry

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What is the gold standard for restrictive disease?

Lung volumes & capacities

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What does the DLCO measure?

Conductance of gas transfer from the inspired gas to the RBCs (Carbon monoxide [CO] “gas exchange”)

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What are the 4 categories used to classify lung disease?

• obstructive
• restrictive
• mixed or combined
• pulmonary vascular disease

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What are the 2 types of PFTs?

standard & specialized

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What do standard PFTs consist of?

• spirometry
• DLCO
• lung volumes

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Name 3 different specialized PFTs?

• ABG
• 6 min walk test
• exercise oximetry

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Name a few things you should consider/notify the patient of when preparing for a test?

• no smoking
• no caffeine
• no large meals
• withhold meds
• no perfumes or colognes

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How long should you withhold these meds?
Bronchodilators, Steroids, Maintenance drugs, Anticholinergic drugs?

Bronchodilators = 4-6 hrs
Steroids = never withhold
Maintenance drugs = 12 hrs
Anticholinergic = 24 hrs

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What demographics should we consider for PFTs? What is the last one that is not included but we should still consider?

•Height
• Age
• Race
• Gender
weight

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PFTs are _______ dependent

Effort

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Tests must be ________ and ________

Acceptable ; replicable

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Name 3 reasons a test may be invalid?

Coughing
Pain
Poor pt effort

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To get valid results pt must be ________

Coached

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What are some things you should do when you get invalid test results?

• re- instruct
• re demonstrate
• re encourage
• ask another therapist
• try again

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You must get ______ replicable tests in a maximum of ______ attempts

3 ; 8

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What are the 2 types of vitals capacity?

SVC & FVC

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What does SVC measure?

Total volume of air that can be exhaled after a maximum inspiration (relaxed)

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What does FVC measure?

Total volume of air that can be exhaled out of the lungs after a maximum inhalation (blast it out! Forced)

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What is the most widely used test in PFTs?

FVC

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What circumstances would you see the SVC smaller than the the FVC? What does this indicate?

Never ; poor or effort

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What circumstance would you see the FVC larger than the SVC?

Air trapping

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What does the FEV1 measure? What is it measured during?

Amount of air measured in 1 sec? The FVC

How much air should you be able to blow out in the FEV1? If the pt blows out less what does that tell you?

75% ; severity

What does the FEV1/FVC ratio define?

If there is an obstruction

What does the FEV1 define?

The severity of obstruction (or restriction)

What percentage indicates obstruction of the FEV1/FVC is less than?

75%

FVC is used for _______?

Validation

If the FVC is normal or higher than_____% you have an _______ only.

80 ; obstruction

If the FVC is less than ______ % you may have an ________ ________ as well or a ________ ________.

80 ; restrictive component ; mixed effect

FEV1 less than or equal too ___% to determine _______.

80 ; severity

Put these in order from most important to less important for interpretation of PFTs? **(FVC, FEV1, FEV1/FVC ratio)**

2.FVC 1.FEV1/FVC ratio 3.FEV1

What are the percentage value ranges for the classification of the severity measurements of FEV1

Mild = 70 to 79% Moderate = 60 to 69% Moderately severe = 50 to 59% Severe = 35 to 49% Very severe < 35%

What type of flow volume loop is this?

Normal flow loop

What type of flow volume loop is this?

Air trapping

What type of flow volume loop is this?

Obstructed upper airway

What type of low volume loop is this?

Small volume in, small volume out

FEF 25 - 75% is measured during the ______ and after _______ .

FVC ; peak expiratory flow

FEF 25 to 75% measures flow at which percentages?

• 25% • 75 %

Which test is the most accurate measure to determine patient effort?

FEF 50%

Three test should be within _______ % of the FVC to meet criteria?

Peak flow is defined as?

Maximal inspiration followed by maximal expiration

What are the demographics we should consider for peak flow

Height Age Gender

What patient population uses peak flow a lot

Asthma patients

How many times/breaths should you do daily for peak flow? How long should you record results for?

3 times/breaths ; 2 weeks

Describe the different zones for peak flow?

**Green zone** = all symptoms go symptom-free and managing adequately **Yellow zone** = caution symptoms worsening contact your position **Red zone** = danger! notify your physician or go

What are the percentages for the three zones?

Green = 80 to 100% Yellow = 50 to 79% Red <50 %

The MVV is maximum _______ and full _______ .

Inspiration ; expiration

During the MVV, the patient will have what type of breathing?

Rapid, forced breathing

During the MVV the patient is breathing ____ to _____ bpm and the test must last ____ to _____ seconds long.

90-100 ; 12-15

What are the three things that the MVV measures?

Resistance Lung compliance Respiratory muscle strength

What are the pre-and post-bronchodilator studies used to determine?

Reversibility of airway obstruction

What is the most commonly used drug in pre-post a bronchidilators studies?

Albuterol

Why do we use a high dose of albuterol in the pre-and post bronchodilator studies?

Albuterol has a rapid onset time

You should stop an albuterol treatment if your patients heart rate increases by how much?

25 bpm

**T or F** Levelalbuterol or Atrovent may be used in place of albuterol if the patient cannot/will not tolerate the increase in heart rate because these drugs do not have the effect?

True

The FVC or FEV1 should increase by how much to indicate if the response to bronchodilator treatment is significant?

12% or more

How far away from the mouth should a patient hold an MDI?

1 inch

How long should a patient wait between breaths? Why?

30 seconds to one minute; time to observe any adverse reactions and give medication time to activate

How long should the inspiratory hold last after inhaling the medication from an MDI?

5 to 10 seconds

If an MDI or DPI contain steroids, what must the patient do? Why?

Rinse their mouth; failure to rinse can cause oral thrush

Ch. 1 & 2 Quiz Flashcards

(63 cards)