Professional Documents
Culture Documents
● Abdominal aneurysm
Lecturer: Dean Socorro Cora S. Gasco
● Cerebral aneurysm
● Recent eye surgery
DEFINITION
● Recent abdominal or thoracic surgical procedure
➢ Measure lung volume, lung mechanism and
● Patients with hx of syncope associated with
lung diffusion capacities
forced exhalation
➢ Measure respiratory volume
● Patients with active TB should not be tested
➢ Measures abnormalities in respiratory
function
➢ Measured by spirometry
COMPLICATIONS
➢ Lung volume determination is measured by
● Trigger an asthmatic episode
PLETHYSMOGRAPHY
● Temporarily irritate breathing symptoms
➢ Measured by spirometry, measures restrictive
● Cross infection due to use of mouthpiece
lung disease, like COPD, measures how well
● Collapse of the lung
the lung exhale
● Pneumothorax
➢ Lung volume determination is measured by
● Nosocomial infections
➢ plethysmography or body box
● Increased ICP
➢ A measure of expiratory flow is obtained with
● Oxygen desaturation
a handheld device is called a peak-flow
● Fainting
● Bronchospasm
LUNG VOLUMES AND CAPACITIES ● Paroxysmal coughing
❏ Vital capacity - volume of air that is measured ● Chest pain
during a slow, maximal expiration after a maximal
inspiration (4800 mL) PROCEDURE
❏ Inspiratory capacity - largest volume of air that Ask the client to take a deep breath, and blow out as
can be inhaled from resting expiratory volume hard as you can, and expire through a mouthpiece
(3000 mL) until he feels there is no more air left in the lungs. His
❏ Functional residual capacity - largest volume of lips should be sealed tightly, put a clip on the nose.
air exhaled from end-expiratory level (2400 mL) Mouthpiece should be sealed by the lips. All of the air
❏ Inspiratory reserve volume - volume of air that of the client breath in and out should be measured to
can be inhaled from a tidal volume level (31000 be accurate. Repeat the test 3 times to ensure an
mL) accurate reading.
❏ Residual volume - volume of air remaining in the
lungs at the end of maximal expiration (1200 mL)
❏ Total lung capacity - volume of air contained in
Maximum Voluntary Ventilation (MVV)
the lungs after maximal inspiration (6000 mL)
1. Like the FML test, put a clip into the patient's nose
❏ Tidal volume - volume of air inhaled or exhaled
and ask him to tightly seal his lips around the
during respiratory cycle (400 mL - 700 mL)
mouthpiece
2. Ask the client to breathe deep and fast for 12 to 15
PURPOSE
seconds, without stopping
● To show reduction in using volume especially
3. This test also be done 3 times for accuracy
with patients with COPD, restrictive or
obstructive lung disorder
Post bronchodilator testing
● To test your lung function before surgery
- To ask the client to breath in a medicine,
● To help diagnose lung conditions or diseases
bronchodilator, that will relax the muscles around the
● To check the extent of lung disease or to help
airway, then repeat. To ask the client to breath in a
explain new breathing symptoms
medicine, bronchodilator, that will relax the muscles
● To check if you are having side effects from
around the airway, then repeat the flow volume
some medicines that can make breathing difficult
(inaudible)
INDICATION
Total Lung capacity
1. Chronic shortness of breath
These three tests measure lung volume to determine
2. Asthma
total lung capacity.
3. COPD
- The normal amount of air your breath in and out
4. Restrictive lung disease
- The maximum amount of air you breath in and out
5. Preoperative testing for surgery, impairment or
- The amount of air remaining in your lungs
disability poor early morning wheezing
Lung Volume Determination
- Is measured by a gas dilution technique or body
CONTRAINDICATION
plethysmography. These tests are the most often
● Hemoptysis
used to measure functional residual capacity (FRC):
● Pneumothorax
● Unstable angina pectoris
● Recent MI
Two types: Below 91 – emergency
1. Open circuit nitrogen method – all exhaled gas below 70 or 80 - life threatening
is collected while the client breathes pure oxygen.
Measurement of the total amount of nitrogen washed
out from the lungs permits calculation of the volume MATERIAL
of gas present in the lungs at the beginning of the Pulse oximeter - a non-invasive device that estimates
maneuver; also allows assessment of the uniformity of a client's arterial blood oxygen saturation (SaO2) by
ventilation in the lungs means of a sensor attached to the client
2. Closed circuit helium method – helium is used to INDICATION
test the lungs, the client inhales a mixture of air with ● Detect abnormal circulation (shunts) in tje blood
a known concentration of helium. Helium does not vessels of the lungs (pulmonary vessels)
significantly diffuse into the pulmonary bed. The ● Test regional (different lung areas) lung function
helium diffuses throughout the air in the breathing in people with advanced pulmonary diseases
box and lungs. Changes in helium concentration in such as COPD
the box are computed to determine the total lung ● To monitor arterial oxygen saturation
volume. ● To detect hypoxemia
● Oxygen therapy
Plethysmograph or body box – is a device used to ● Dyspnea
measure lung volumes. The lung volume changes that ● Cardiac problems
occur with obstructive and restrictive lung disorders. ● Cyatonic
- While sitting in the airtight box, the client is
instructed to perform a panting maneuver. Changes CONTRAINDICATION
in the box pressure reflect changes in thoracic ● Abnormal hemoglobin
volume. Clients who cannot pant, who cannot tolerate ● Takes vasopressors drugs
closed spaces, or who have equipment that would ● Highly callous skin
interfere with the procedure cannot be tested by this ● Shivering
method ● Carbon monoxide poisoning
● Hyperbilirubinemia
Procedure (KAN MAAM INI PINANYAKAN)
- The client will sit inside an airtight box COMPLICATIONS
- Blow out slowly ● Negative Result hypoxemia
- Helium dilution method ● Negative Result Normoxemia
- Lip sealed clip his nose. Client will breath in a ● Negative Result hyperoxemia
mixture of helium. and oxygen. Lasts for 3-7 minutes
- Then the client will deep breath and blow out
Nursing responsibility
● Make sure there is no nail polish
FACTORS AFFECTING RESULTS ● Check for pigmentation
● Failure to follow instructions ● Check for Low perfusion
● Anxiety or fatigue ● Pulse oximetry cannot discriminate between
● Recent or current respiratory diseases ● hemoglobin sat and carbon monoxide
● Bronchodilators, sedatives, and other drugs that ● Check alarm limits then ensure client safety
affect breathing or all body systems
● Time of the day: PFT tends to arise and then fall
from morning to evening Arterial Blood Gas Analysis
– involves the use of arterial rather than venous,
blood to measure PaO2 (reflects the efficiency of gas
PULSE OXIMETRY exchange), PaCO2 (reflects the effectiveness of
DEFINITION alveolar ventilation), and pH directly.
➢ Provides estimates of arterial oxyhemoglobin
(SaO2) by utilizing wavelengths of light to Ventilation perfusion lung scan
non-invasively determine the saturation of – to see how well air moves and how well blood will
oxyhemoglobin (Sp02) go to the lungs; used to assess lung ventilation and
➢ “fifth vital sign”; noninvasive that estimates lung perfusion
arterial blood oxygen saturation (SaO2) (it could - To detect pulmonary embolism, pulmonary
be in the index finger, middle finger, ear lobe, infarction, emphysema, fibrosis, and
nose, forehead?), by means of a sensor attached bronchiectasis.
to the client; Neonates hands or foot nose
earlobe index finger or middle finger toes or Indication
forehead ● Patient with COPD
● Abnormal air in the lungs pneumothorax
95-100% - normal
● Detect abnormal circulation (shunts) in the blood
vessels of the lungs (pulmonary vessels)
● Test regional (different lung areas) lung function
in people with advanced pulmonary diseases,
such as COPD
Symptoms
● Dyspnea
● Rapid heart late
● Decreased oxygen saturation
● Chest pain
● Ashen gray
Contraindication
● Allergic to radio isotope
● Allergic to seafood
● Allergic to Radiation
● Allergic to Iodine
● Pregnant
● Breast cancer
Radionuclide dye introduced in to the bloodstream
through a needle, with the dye injected, the
technician will remove the IV and you will then be
moved in a special scanner. It will show the flow of
dye in your bloodstream. To see obstruction a
mouthpiece will be given which contains gas