respiratory and cardiac diagnostic tests

Question 1

arterial blood gas (ABG)

Answer 1

conditions: PE
performed if pt is in respiratory distress
if a pt has a PE the ABG will show hypoxemia (PaO2 < 80) and respiratory alkalosis (PaCO2 < 35) due to the pt’s increased RR

Question 2

CBC

Answer 2

checks oxygenation and platelets for bleeding and clotting

Question 3

D-Dimer

Answer 3

checks for presence of a clot in the body
increased D-Dimer = clot
negative D-Dimer = no clot

Question 4

Mantoux skin/serum IGRA

Answer 4

assesses for TB exposure/infection

Question 5

sputum culture

Answer 5

checks for bacteria i.e. respiratory infections

Question 6

biopsy

Answer 6

diagnoses lung cancer etc

Question 7

pulse oximetry

Answer 7

used to monitor oxygenation
95-100% is normal but pts with chronic respiratory issues may have lower baslines

Question 8

chest x-ray for respiratory issues

Answer 8

rules out other causes of respiratory distress
may show an underlying pathology like pneumonia or pneumothorax that can explain the symptoms

Question 9

CT scan/spiral CT scan

Answer 9

spiral CT scan: identifies PEs

Question 10

MRI

Answer 10

if contrast is being used: check kidney function (BUN and creatinine), give fluids after, ask about shellfish allergy
screen for metal: implant, pacemaker, metal plates, screws
x-rays can show metal if unsure

Question 11

ventilation/perfusion (V/Q) scan

Answer 11

used if a CT scan isn’t available
identifies the areas of the lungs that are ventilated but are not perfusing effectively
less specific and takes longer than a CT scan

Question 12

PET scan

Answer 12

Done when they suspect cancer
Full body scan
Contrast material with glucose is injected
For diabetics: more insulin and frequent BS checks

Question 13

pulmonary function studies / peak flow

Answer 13

peak flow: asthma; measures how well they’re expiring air; portable device they blow into
pulm function: determine how much air the lungs can hold; gives an idea of the status of lungs especially in pts with chronic lung disease

Question 14

bronchoscopy

Answer 14

allows for direct visualization of the respiratory tract
NPO for 8 hours before the procedure

Question 15

thoracentesis

Answer 15

excess fluid is removed from the pleural space
after the procedure: vital signs, respiratory assessment, lung sounds
assess for s/s pneumothorax
encourage pt to cough and deep breathe following the procedure
assess area for drainage and bleeding; a minimal amount of blood is normal

Question 16

creatinine kinase (ck-mb)

Answer 16

used to diagnose MIs
not preferred over troponin due to short testing window

Question 17

troponin

Answer 17

released after myocardial cell death
the higher the troponin, the greater the damage
levels detectable for 10-14 days
3 troponins are drawn to diagnose an MI

Question 18

high sensitivity troponin

Answer 18

more precise
identifies low-risk pts eligible for early discharge
drawn upon admission and one hour later

Question 19

homocysteine

Answer 19

byproduct of protein metabolism
when levels are elevated, blood clotting may increase
treat with folic acid/B vitamin complex

Question 20

c-reactive protein (hs-crp)

Answer 20

reflective of inflammation of coronary arteries
treatment: aspirin, stop smoking, exercise, lipid lowering agents

Question 21

serum lipids

Answer 21

triglycerides: < 150
HDL: 40-60
LDL: < 100
total cholesterol: < 200

Question 22

ankle-brachial index (ABI)

Answer 22

condition: peripheral vascular disease
BP measurement in arm and leg
tells you how well that extremity is being perfused

Question 23

holter monitoring

Answer 23

recording of EKG rhythm for 24-48 hours
instruct pt to keep a log of what they are doing

Question 24

echocardiogram

Answer 24

diagnostic test for HF
ultrasound of heart
can measure heart structures and size, blood flow, and ejection fraction

Question 25

ejection fraction

Answer 25

% of blood volume ejected during systole should be > 50%

Question 26

transesophageal echocardiography (TEE)

Answer 26

used if they need to look at the structure behind the heart goes in through the esophagus not for pts with esophageal disorders like reflux check gag reflex!!!!!! no eating or drinking until gag reflex returns

Question 27

exercise stress test

Answer 27

involves walking on a treadmill ECG and BP recording before, during, and after exercise pts should report any chest pain or SOB during the test

Question 28

stress ECHO

Answer 28

same as exercise stress test but includes echo ultrasound before and immediately after exercise pt needs to get back on table as soon as exercise stops so images can be obtained

Question 29

chemical stress test

Answer 29

used if pt cannot walk on treadmill studies involve injection of isotopes scans are repeated before and after exercise for comparison

Question 30

chest x-ray for cardiovascular issues

Answer 30

general screening for size, shape, and position of the heart not diagnostic but can show concerns like hypertrophy or pulmonary congestion

Question 31

coronary calcium scan

Answer 31

CT of heart checks plaque formation in the coronary arteries no smoking or caffeine 4 hours before the test

Question 32

cardiac catheterization

Answer 32

dye is injected into the coronary arteries to evaluate condition/blood flow preop: iv access, NPO 6-8 hours, check liver function, baseline assessments ESP pulses, sedation to relax pt intra-op: warn pt about flushing feeling; monitor cardiac status post-op: pt lies flat for 2-6 hours; check site for bleeding; hydration; frequent vital signs; check pulses q15 mins