Ch. 10 Specialized Test Regimen Flashcards

(34 cards)

1
Q

Who are some candidates for exercise testing?

A

• Normal PFT but has SOB on exertion
• Other tests (such as metacholine and histamine challenge) were normal but pt is symptomatic
• Evaluating therapy is know EIA

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2
Q

Exercise challenge:
Do not repeat test for at least _____ hrs.

A

4

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3
Q

Exercise testing:
Be prepared to reverse ________.

A

Bronchospasm

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4
Q

What do you need for pre-test prep?

A

• history and physical
• EKG
• No bronchodilator prior to test
• FEV1 should be no less than 65% of predicted
• no vigorous exercise for 4 hours prior
• no respiratory infection 3-6 weeks prior

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5
Q

Testing:
Workload should be _________of max heart rate for _______.

A

80-90%; 4-6mins

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6
Q

Testing:
_______ or _______can be used

A

Treadmill or cycle

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7
Q

Testing:
_______ of low intensity workload (observe pt for changes)

A

1-2mins

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8
Q

What do you monitor during and after testing?

A

• BP
• HR
• SpO2
• EKG

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9
Q

During and after test:
FEV1 has to be ______ & _______ and within ______ of each other.

A

Repeatable; acceptable; 5%

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10
Q

Positive exercise challenge test:
Dec of _____ FEV1 is consistent with airway hyperactivity?

A

10-15%

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11
Q

Positive exercise testing:
In healthy pt exercise will _____ FEV1?

A

Increase

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12
Q

Eucapnic Voluntary Hypoventilation:
______ is added to prevent hyperventilation. We are creating CO2 _____.

A

CO2; narcosis

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13
Q

Performing test:
Baseline spirometry is performed with ______?

A

MVV

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14
Q

Performing test:
Mixture of air is passed over a heat exchanger or cooling coil to chill air to ______ to _______ degrees Celsius.

A

-10 to -20

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15
Q

Performing test:
Ensure patient has had no ______ prior to testing. We are trying to _______ ________.

A

Bronchodilator; invoke bronchospasm

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16
Q

Cold air method:
CO2 is added to prevent _______ and maintain ______.

A

Hyperventilation; pH

17
Q

Cold air method:
Pt must ventilate at _______ of MVV for _______.

A

60-85%; 4-6min

18
Q

Results:
In a healthy pt EVH will usually cause ______ not bronchospasm.

A

Bronchodilation

19
Q

Results:
You will know it has reactive airway if there is a _____ decrease in FEV1.

20
Q

Results:
After last spirometry is performed results should be reversed with ______?

A

Bronchodilator

21
Q

Enabled notices oxide (ENO):
Measures _______ in the lungs.

22
Q

Enabled notices oxide (ENO):
Specifically _________ inflammation typical with ______& ________ pts

A

Eosinophilic; asthma; COPD

23
Q

Enabled notices oxide (ENO):
Smoking causes a ______ ENO?

24
Q

What should pt not do before test?

A

• no smoking for 1hr
• no eating or drinking few hrs before
• perform before all other tests
• record pt meds and current health status
remember ICS decreases inflammation

25
How to measure ENO?
• online sample exhaled gas continuously at the mouth (most common) • offline measures collected gas in a sampling device
26
How does online measuring work for ENO?
• Pt inhales through a nitric oxide scrubber • exhale to RV • inspires to 2-3 sec to TLC • Gas is exhaled and samples continuously to prevent nasal irritation • No contamination • No nose clip needed
27
**Online measuring ENO:** Exhalation is against ______ exhaled gas should be at ________ ?
+5cmH2O; 0.05L/sec
28
**Online measuring ENO:** Must measure long enough to give a plateau. What at the plateau for children?
• 12 yrs and older > 6sec • Under 12 years > 4sec
29
**Online measuring ENO:** Must have at least _____ acceptable and replicable test within ______ of each other then average them.
2;20%
30
**Offline measuring ENO:**
• sample is collected in balloon • analysis will take place within 12 hrs • pt inhales into TLC through NO scrubber or from reservoir of NO free gas • pt exhales RV into sampling device where resistance is added
31
Nasal nitric oxide (NO)
• Air is aspirated into one side of the nose and out of the other • Against 10cmH2O resistance • Plateau achieved in 20-30 sec • Nasal values are typically higher than exhaled values (epithelial cells) • Sample is taken value and flow are recorded
32
If levels are elevated above the norm think suspect _______ or ________
Eosinophilic inflammation of airways; alveolitis
33
What are the normal FENO levels for adults and children?
Adults: 10-35ppb Children: 5-25ppb
34
The numbers are good for monitoring _______?
Therapy