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Cardiopulmonary Diagnostic (PFTs) > Introduction to PFT's > Flashcards

Introduction to PFT's Flashcards

(79 cards)

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1
Q

What are some indications for PFT’s (4)

A
  • Diagnosis (restrictive or obstructive)
  • Screening
  • Monitoring
  • Effects of chemical and toxic medications
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2
Q

What do PFT’s measure (3)

A
  • Spirometry (Obstructive)
  • Lung Volumes (Restrictive)
  • Diffusion Capacity of Carbon Monoxide (DLCO)
    (it determines gas exchange)
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3
Q

Spirometry is defined as

A

the flow of air in and out of the lungs

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4
Q

Spirometry is considered the ______ ___________ test for diagnosing _____________ lung diseases

A

GOLD STANDARD;
Obstructive

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5
Q

What are the 3 factors in doing a spirometry test?

A
  • Determining the severity of COPD or its progress
  • Measuring the response to bronchodilators
  • Assessing the risk of pulmonary disease
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6
Q

Lung volume is defined as the amount of air in the lungs at different

A

phases of the respiratory cycle

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7
Q

Lung volumes are most commonly used for diagnosing and assessing _____________ lung disease

A

restrictive

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8
Q

Diffusion Capacity for Carbon Monoxide is defined as a measure of the conductance of

A

gas transfer from inspired gas to RBC (gas exchange)

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9
Q

PFT’s help to classify lung disease into 1 of 4, what are they (ORMP)

A
  1. Obstructive lung disease (CBABE)
  2. Restrictive disease (ILD, Extrastital lung disease, Chest wall pathology, Neuromuscular disease)
  3. Mixed or combined Lung disease
  4. Pulmonary Vascular Disease
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10
Q

What some types of PFTs

A

standard PFT
- Spirometry (flow volume loops)
- Lung volumes and capacities
- DLCO

specialized PFT
- ABG
- 6 minute walk

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11
Q

While preparing for a test bronchodilators should not be taking

A

4 hrs prior to test, unless needed

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12
Q

How many hours before a test for maintenance meds (Symbicort, brovana, Advair)

A

12 hrs

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13
Q

Which type of drug should not be withheld prior for a test

A

Steroids (Predniosne, pulimcort)

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14
Q

Pts should not have these prior to test (4)

A
  • caffeine
  • smoking
  • large meals
  • perfumes
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15
Q

Predicted values come from a national database and are based on 4 demographics

A

HGAR
- height
- gender
- age
-race

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16
Q

PFT test are

A

effort dependent

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17
Q

PFT test must be ______________ and ______________

A

Acceptable and Replicable

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18
Q

To get valid results the pt must be

A

coached

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19
Q

_____________ the procedure and ______________ best effort

A

Explain; encourage

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20
Q

______________ the test maneuver

A

Demonstrate

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21
Q

If a test is not replicable…..

A

it is not valid

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22
Q

Reasons for an invalid test (5)

A
  • not understanding directions
  • lack of coordination
  • poor effort
  • pain
  • couging
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23
Q

What do we do if you get an invalid results (5)

A
  • Try again
  • Resinstruct the pt
  • Redemonstrate the maneuver
  • Ask another therapist to assist
  • make comments on pt’s report
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24
Q

How many replicable test do we need?

A

3

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25
A pt has a maximum of how many attempts?
8
26
A vital capacity can be _______ or _______
slow or forced
27
Slow vital capacity (svc) measures the TOTAL VOLUME of air
**exhaled** out of the lungs after a maximum inhalation (relaxed)
28
Forced vital capacity (FVC) measures the
TOTAL VOLUME of air **out** of the lungs after a maximum inhalation (blast it out)
29
Which test is most widely used in PFTs?
Forced Vital Capacity (FVC)
30
SVC should never....
be smaller than FVC
31
What does it mean if SVC is smaller than FVC?
poor pt effort
32
What circumstances would you see the SVC larger?
obstruction
33
SVC should only be greater than FVC during an
obstruction (air trapping)
34
What disease process would SVC be greater than FVC (2)
- Emphysema - Asthma
35
During SVC the pt has
**Plenty** of time to get all the air out
36
During FVC the pt has
**Limited** time to get the air out
37
When is Forced Expiratory Volume over 1 second (FEV1) measured?
During the FVC
38
What does **FEV1/FVC ratio** determine?
If there is an obstruction
39
What does **FEV1** determine?
the degree of the obstruction
40
If FEV1/FVC ratio is < ____% predicted, what does that indicates?
75%; indicates an obstruction disease (CBABE)
41
FVC validation; If FVC is **normal/ high** (80%) you have an
obstruction only
42
If the FVC is **low** <80% you may have a
restrictive component (mixed)
43
FEV1 < 80% is used to determine the what? List them.
severity; Mild, moderate, moderately severe, severe, or very severe
44
Classification of Severity of FEV1 Mild
70-79%
45
Classification of Severity of FEV1 Moderate
60-69%
46
Classification of Severity of FEV1 Moderately severe
50-59%
47
Classification of Severity of FEV1 Severe
35-49%
48
Classification of Severity of FEV1 Very Servere
<35%
49
Forced Expiratory Flow (FEF) is measured ...
during FVC
50
FEF 25%- 75% is measured at
25% and 75% of the exhalation
51
FEF 25%-75% reflects...
abnormalities in the small airways
52
_______ is the most ____________ measure used to determine patient effort
FEF 50%; accurate;
53
Peak flow is defined as a
maximal inspiratory, followed by a maximal **forced** exhalation
54
Predicted values for peak flow are based on?(3)
- height - age - gender
55
Asthmatics can be measured w/
peak flow meter or during spirometry testing
56
While using peak flow what should be recorded and for how long?
- The highest # breath (3 breaths daily) - 2 weeks
57
What is the Green zone
80 to 100% relatively free of symptoms and can maintain current asthma management
58
What is the yellow zone?
50 to 79% "caution" As asthma symptoms worsen, contact Dr to fine-tune regiment
59
What is the Red zone?
<50% "Danger" Tx isn't controlling your symptoms
60
Maximum Voluntary Ventilation (MVV) is the
maximum inhalation and full exhalation; Rapid forced breathing (90 to 100 bpm) in 12 to 15 seconds
61
At least ___ MVV tests should be performed and should be within ___% of each other
2; 20%
62
During a MVV test you should report the
highest breath rate
63
MVV also measures ___________, _____________ and _________ muscle strength
resistance; compliance; respiratory
64
How do we know if the response is significant?
An increase in FVC of 12% or more is considered significant
65
List the proper way to use an MDI
- Shake the MDI (prime if needed) - Hold MDI slightly away from the pt's or use a spacer (preferred method) - Instruct pt to begin inhaling slowly to activate the MDI - Have pt continue to inhale maximal inspiration - Instruct pt to hold the breath for 5 to 10 sec, followed by a slow exhalation - Repeat 1 minute in between dose
66
**From Quiz** What is the Gold standard PFT test considered for diagnosing Obstructive disease?
Spirometry
67
Which standard PFT is used to diagnose Restrictive /disease
Lung Volumes
68
What does DLCO measure?
Gas exchange
69
What 4 demographics are used in the national data base to predict normal values?
**HGAR** - Height - Gender - Age - Race
70
Test results are __________ dependent and must be __________ to get valid results
effort; coached
71
In order for a PFT to be valid it must be _____________ and ____________
acceptable; replicated
72
Explain in detail what you should do if you get invalid results
- Try again - Resinstruct the pt - Redemonstrate the manuever - Ask another Therapist to help - Make comments on pt's record
73
**Last question from quiz** Name 3 or more indications for PFTs
- Diagnosis (restrictive or obstructive) - Screening (To access symptoms, the risk for lung disease, pre-op) - Monitoring (effectiveness of medications and therapy) - Effects of chemicals and toxic medications (mosaic, firefighters, meds such as Amiodarone)
74
FEV1/FVC Ratio defines
obstruction
75
FEV1 defines the
degree of the obstruction
76
If FEV1/FVC ratio is _____ ______ ____% predicted it indictaes an ____________ disease (________)
less than 75%; obstructive; CBABE
77
If the FVC is normal/high (80%) you have an.....
obstruction only
78
If the FVC is low (<80%) you may have a....
restrictive component (mixed)
79
FEV1 <80% to determine the severity it is
Mild, moderate, moderately severe, severe, or very severe

Cardiopulmonary Diagnostic (PFTs) (6 decks)

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