NSG 550 Diagnostics Study Guide Quiz #2
Pulmonary Diagnostics Quiz #2
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Pulmonary Function Tests/Spirometry
o Varies w/ age, sex, height, weight
o Used to eval: Preop eval of lungs and pulmonary reserve, response to
bronchodilator therapy, differentiate between restrictive and obstructive chronic
pulmonary disease, determine diffusing capacity of lungs, inhalation allergy
tests
o Routinely include spirometry, airflow measurement, lung volume and capacity
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Forced vital capacity (FVC): Amount of air that can be forcefully expelled
from a maximally inflated lung position. Less than expected values occur
in obstructive and restrictive pulmonary diseases.
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Forced expiratory volume in 1 second (FEV1): Volume of air expelled
during the first second of FVC. In obstructive pulmonary disease, airways
are narrowed and resistance to flow is high. Therefore not so much air can
be expelled in 1 second, and FEV1 is less than the predicted value. In
restrictive lung disease, FEV1 is decreased because the amount of air
originally inhaled is low, not because of airway resistance. Therefore the
FEV1/FVC ratio should be measured. In restrictive lung disease a normal
value is 80%, and in obstructive lung disease this ratio is considerably
less. The FEV1 value will reliably improve with bronchodilator therapy if
a spastic component to obstructive pulmonary disease exists. .
o Spirometry: Greater than 80% of expected value is normal
o Airflow rate: Diminished at less than 60% of normal. Increase of 20% with
bronchodilator = prescribe
o Diagnosis of COPD requires demonstration of persistent airflow limitation based
on spirometry testing, generally defined as post bronchodilator FEV1/FVC <70%.
Classification of COPD severity should be determined by the assessment of
spirometry testing at regular intervals. Some risk factors for COPD include
smoking, pollution exposure, and genetic predisposition. COPD typically has an
onset later in life and a slower progression of symptoms as compared to asthma.
Additionally, COPD has a poorer response to inhaled therapy as compared to
asthma.
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Polysomnography (Sleep study)
o Indicated in any person who snores excessively; experiences narcolepsy,
excessive daytime sleeping, or insomnia; or has motor spasms while sleeping; and
in patients with documented cardiac rhythm disturbances limited to sleep time.
o Sleep apnea
o Actigraphy: Watch that can be worn a few nights – at home
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Bronchoscopy
o Used for performing various diagnostic and therapeutic procedures.
o Visualization of the tracheobronchial tree; transbronchial and endobronchial
biopsies; bronchoalveolar lavage; removal of foreign bodies, clots, mucus plugs;
and deployment of metallic stents. Aspiration of deep sputum, control of bleeding
