COMPS: Pulmonary Dx Tests/Procedures: Exam 1 Flashcards
(94 cards)
1
Q
pH
Normal Value vs. Normal Range
A
- Normal value ==== 7.40
- Normal range===7.35-7.45
2
Q
Metabolic Acidosis
*Diabetic Ketoacidosis
A
3
Q
Respiratory Alkalosis
A
- PaCO2<35; DEC PaCO2= DEC pH
- hypERventilation
- tachycardia
- hypOkalemia
4
Q
INvasive Pulm tests
A
bronchoscopy
Arterial blood gas analysis (ABG)
Cytological tests
5
Q
PFF table
Normal
Restrictive
Obstructive
A
see pics
6
Q
Hematological tests aid in assess. of what?
A
CP disease
7
Q
Lung Diseases: 2 types
A
- Restrictive
- Obstructive
8
Q
Hematological tests:
Anemia
A
LOW Hb
LOW RBC
LOW Hematocrit
*immune response
9
Q
These are indicated to rule OUT PE
A
V/Q scans
10
Q
V/Q scans
A
- Xenon gas used to measure regional distribution of ventilation in lungs
- pt inhales gas and holds breath while ventilation scans are made over lung field
11
Q
FEV1/FVC=====
A
Air OUT 1sec/Air OUT entire time
12
Q
Cytological Tests are checking for:
A
Bacteria
Fungi
Protozoa
Viruses
13
Q
Flow-volume graph/loop
Normal
Restrictive
Obstructive
A
see pics
14
Q
HCO3-
A
- KIDNEY BASED
- metabolic
- Bicarb is a BASE
- makes blood more BASIC!!!
15
Q
Advantages vs. Disadvantages
Chest CT vs. Chest radiography (xray)
A
see pics
16
Q
ABG
clinical notes:
ABGs are…..
A
time dependent
17
Q
Pulmonary Function Test
all volumes and capacities
A
see pics
18
Q
V/Q scans described by:
A
Neg.
Low Prob of PE
Intermed. Prob of PE
High Prob of PE
19
Q
Abnormal ABG:
Acidosis
A
pH>7.35
PCO2> 45
HCO3- <22
20
Q
What should you remember about “Capacities”
A
HAS TO BE MORE THAN ONE VOLUME ALWAYS
21
Q
Normal Chest radiographs
A
see pics
22
Q
What views taken for chest xray?
what do we WANT to see?
A
- 2 views:
- PA
- L. Lat.
-
we want to see BLACK
- ==> Air in lungs
23
Q
Abnormal ABG
Alkalosis
A
pH >7.45
PCO2 <35
HCO3- >26
24
Q
Hematological tests:
Leukopenia
A
DEC WBC
25
Blood Gas Analysis/ABGs
## Footnote
**Crucial to assess probs related to what?**
Acid-base **balance, ventilation, oxygenation**
26
VC vs. FVC
SAME THING
FVC is 6secs
27
PaO2
NORMAL
80-100
28
Hematological tests:
**Anemia**
**Polycythemia**
**Leukocytosis**
**Leukopenia**
**ALL ARE WHAT?**
IMMUNE RESPONSES
29
Typical Hematological Tests include:
* ABGs
* electrolytes
* CBC's
* coagulation studies
30
Residual volume
NO participation in gas exchange
air we cannot use
31
Total Lung Capacity
**TLC ====**
ALL air in lungs
EVERYTHING added together
**~5L**
32
%SAT should be
\> 95%
33
Range of PaCO2
35-45
34
Chest imaging
chest radiograph
MOST COMMONLY USED DX TEST
where is pt placed?
pt placed b/w x-ray machine & cassette
35
PaO2
## Footnote
**\<80**
* hypoxemia
* **mild= 60-80**
* **mod= 40-60**
* **severe= \<40**
36
ABGS
SEE PICS
37
Chest imaging:
V/Q Scan
**what are we looking for?**
PE
38
Respiratory **Alkalosis**
see pics
39
ABGs in Acute Care
used to assess current cond's
40
PCO2
* LUNGS based (respiratory)
* CO2 is an **ACID**
* **makes blood more acidic!!!**
41
Chest x-rays
Densities
Low vs High vs. Intermediate
Low== air (black on xray)
High== bone (white)
Intermed== fluid and soft tissue (gray)
42
Compensation: **pursuit to Homeostasis**
## Footnote
**Uncompensated**
1 gas & pH is NOT normal
1 gas IS normal
\*nothing is being done to compensate for pH change
43
Typical ABG report:
* **arterial pH**
* **pp's of CO2**
* **pp's of O2**
* O2 sats
* **bicarb concentration** (HCO3)
* based excess
44
Respiratory **Acidosis**
see pics
45
Tidal Volume
TV
NORMAL air in/out
~600mL-- M
~400mL-- F
46
Functional Residual Capacity =====
ERV+ RV
47
PFT is a test of.....
Diffusion
48
Hematological tests:
## Footnote
**Polycythemia**
**INC in:**
Hb
RBC
Hematocrit
49
50
Metabolic **Alkalosis**
see pics
51
Metabolic Acidosis
* PaHCO3- \<22; **DEC PaHCO3- = DEC pH**
* ****hypERkalemia
* **Kussmaul respirations**
* **compensatory hypERvent, diabetic ketoacidosis**
* **severe diarrhea**
* **renal failure**
* **shock**
52
Pulmonary Function Test
What graph is best to used?
see pics !!!
53
NON-invasive Pulm tests:
chest x ray
chest CT
chest V/Q scan
pulm function test (PFF)
oximetry (PulseOx)
54
PFT is the relative diff. b/w partial pressures of gas in \_\_\_\_\_\_\_\_\_
Alveoli and Pulmonary blood
55
ABGs are repeated when?
If ventilator modes OR support change
56
PFF
**Restrictive**
## Footnote
**cannot get air IN**
NOTE: ratios w/ Restrictive and normal are SAME
57
Oximetry is looking for what?
O2 bound to Hb **or anything bound to Hb**
58
Abnormal Chest radiographs
Acute CHF
see pics
59
Compensaton ABGs: Pursuit to **Homeostasis**
## Footnote
**FULL**
BOTH gases either high or low
pH normal
\*both are compensating for pH
60
Metabolic Alkalosis
* PaHCO3- \>26; **INC PaHCO3- = INC pH**
* ****Tachycardia
* compensatory hypOvent.
* severe vomiting
* excess. GI suctioning
* diuretics
* excessive NaHCO3
61
PFF:
## Footnote
**Obstructive**
**can't get air OUT**
MASSIVE TLC
HIGHER TLC
62
V/Q scans
## Footnote
**how do you measure regional distrib. of Pulmonary blood flow in lungs**
* pt injected intravenously w/ **radioactive iodine**
* ******serial _perfustion_ scans made**
63
Invasive Pulmonary tests or...
INSIDE body
64
Chest imaging
## Footnote
**Bronchoscopy**
* Fiber optic bronchoscopy
* goes DOWN airways
65
Amt of gas entering pulm blood flow per unit time
PFT
66
Chest imagining chest CT
**WHAT IS IT**
digital chest radiography
## Footnote
**narrow beam of x-rays move across field of exam.**
67
Oximetry is measurement of?
Oxyhemoglobin saturation
* PulseOx
* quick/accurate
68
Inspiratory Capacity ====
IRV + TV
69
How do we take ABGs?
**Arterial sample**
**\*\***Quick ID of **4 primary disorders based on pH and CO2**
70
Non-invasive Pulm tests:
Chest imaging
**chest radiograph**
**MOST COMMONLY USED DX TEST**
* Det's anatomic abnorms & patho. processes w/in chest
71
Lung Diseases:
Restr**i**ct**i**ve ===
MORE i's
Cannot get air IN
more I's in restrictive===can't get air **I**n
72
Compensation ABGs: **pursuit to Homeostasis**
## Footnote
**Partial**
pH normal
1 gas is normal
\*1 gas trying to compensate for pH
73
V/Q Scan pics
see attached
74
Respiratory Acidosis ===
* PaCO2 \<35; **DEC PaCO2== INC pH**
* **hypOvent.== hypoxia**
* **hypERkalemia== INC K+**
* **RESPIRATORY depression**
* **airway obstruction**
75
Bicarbonate or HCO3-
## Footnote
**Normal Value vs. Normal Range**
* Normal value === 24
* Normal range==22-26
76
OPP. of V/Q scan
PFT
* Diffusing capacity of Lung
* **DL**
* Diffusing capacity of Lung for Carbon Monoxide
* **DLCO**
77
Normal PFF
Normal ratios
78
Blood Gas Analysis/ABGs
\***ABG Ninja!!!**
**USE IT!!!**
SEE PICS
79
PCO2
## Footnote
**Normal value vs. Normal Range**
* **Normal value === 40**
* **Normal range == 35-45**
## Footnote
**\*\*\*SAME AS pH....kinda!!!**
80
Inspiratory Reserve Volume
IRV
Breating in as deep as you can AFTER normal breath
## Footnote
**after TV**
81
Expiratory Reserve Volume
ERV
all air we can force OUT of lungs **AFTER NORMAL EXHALE**
82
Normal Range of O2 should be....
\>80
83
ABGs and **Venous blood gases**
CAN provide status of **pH and PaCO2**
84
Vital Capacity
MAX inhale to MAX exhale
85
Hematological tests:
## Footnote
**Leukocytosis**
INC WBC
86
FEV1 ====
forced Exp volume in 1 sec
87
PFT:
## Footnote
**abnorm values attributed to 3 key factors:**
* 1. DECd perfusion
* 2. INCd thickness of **capillary-alveolar membrane**
* 3. DECd functional surf. area of **capillary-alveolar membrane**
88
When FEV1/FVC is LOWER or SLOWER ====
Obstructive
LOWER==more severe
89
Chest CT primary use
dx of **tumors** and **PE**
## Footnote
**360deg x-rays**
**HIGH res. pics**
90
Bronchoscopy indicated to assess for:
* **integrity** of airways
* DEEP specific suctioning of **viscous secretions**
* **Bronchial anastomosis issues**
* **Condition** of lung tissue
91
V/Q Scans
V/Q
**Zones of West**
92
PFT is a **measure of integrity of function of the lung unit OR**
Alveolar Function
93
Lung Diseases
**O**bstructive
more o's
Cannot get air **O**UT
More O's in Obstructive
can't get air OUT
94
when FEV1/FVC is HIGHER =====
Restrictive
MORE restriction
