Oxygenation
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| Hemoglobin Study | Reflects amount of hemoglobin - Male: 13.2-17.3 g/dl - Female: 11.7-16.o g/dl
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| Hematocrit Study | Ratio of RBC cells to plasma - Males: 39%-50% - Femals35%-47%
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| Polycythemia | Increased hematocrit level - found in chronic hpoxemia
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| ABGs | Obtained through puncture of radial or femoral artery
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| Oximetry | Monitors arterial or venous O2 saturation (SpO2)
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| End-tidal CO2 (PEET CO2) (capnography) | Assesses level of CO2 in exhale air - PaCo2 35-45 mm Hg - PETCO2 37-50 mm Hg)
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| Culture and Sensitivity Sputum Study | Purpose: Dx bacterial infection - Takes 48-72 hours for results
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| Gram Stain Sputum Study | Permits classification of bacteria into gram-negative and gram-positive to help guide therapy until culture and sensitivity results are obtained - obtain sputum (mucoidike) not saliva
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| Acid-fast Smear and Culture Study | Assess sputum for acid-fast bacilli - A series of three early-morning specimens is used
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| Cytolgy Study | Determines presence of abnormal cells that may indicate malignant conditions
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| Mediastinoscopy | Scope is inserted through a small incision in the suprasternal notch and advanced into the mediastinum to inspect and biopsy lympth nodes - Dx cancer - prepare pt for surgical intervention
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| Lung Biopsy | Specimens may be obtained by transbronchial or percutaneous biopsy or via transthoracic needle aspiration - used to obtain specimens for laboratory analysis
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| Thoracentesis | Used to obtain specimen of pleural fluid for Dx, to remove pleural fluid, or instill medication - Chest x-ray is always obtained after procedure to check for pneumothorax
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| Thoracentesis | Position pt upright W/ elbows on an overbed table and feet supported - Observe for signs if hypoxia and pneumothorax, and verify breath sounds in a ll fields after procedure - Encourage deep breathing to expand lungs
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| Pulmonary Function Test | Used to evaluate lung function - Uses spirometer to assess air movement as pt performs prescribed respiratory maneuvers - Avoid scheduling immediately after mealtime - Avoid administration of inhaled bronchodialtor 6 Hr before procedure - Provide rest
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| Exercise Testing | Used to Dx and in determining exercise capacity - Encourage pt to walk as quickly as possible
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| 6-min Walk Test | Used to measure functional capacity and response to treatment in pts W/ HD or lung disease - Pt is instructed to walk as far as possible during 6 minutes, stopping when short of breath and continuing when able
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| Chest X-ray Study | Used to screen, Dx, and evaluate changes in respiatory system, Instruct pt to undress to waist, put on gown, and remove any metal between neck and waist
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| Computed Tomography (CT) Study | Performed for Dx of lesions difficult to assess by conventional x-ray studies (mediastinum, hilum, pleura) - Contrast medium may be given IV - Evaluation of BUN and serum creatinine is done before contrast to assess renal function
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| Computed Tomography (CT) Study | Assess if pt is allergic to shellfish (iodine) - Ensure pt is hydrated before and after to excrete contrast - Contrast may cause a feeling of being warm and flushed -
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| Magnetic Resonance Imaging (MRI) Study | Used for DX of lesions diff, to assess by CT scan (lung apex) - Contrast medium is NOT iodine based - Claustrophobia pt - Remove all metal - Pacemaker pt and implantables may not be able to have MIR
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| Vetilation-perfusion (V/Q) scan Study | Used to access ventilation and perfusion of lungs - IV radiotope given to assess perfusion - For ventilation pt inhales radioactive gas - Homogeneous radioactivity = normal scan - Diminished or absent radioactivity = lack of perfusion or airflow
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| Pulmonary Angiogram Study | To visualize pulmonary vasculature & locate obstruction/pathologic conditions - contract medium is injected through catheter threaded into pulmonary artery or R side of heart - CT contract media precautions - Monitor BP, P, & circulation distal to IV
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| Positron Emission Tomograohy (PET) Scan Study | To distinguish benign & malignant pulmonary nodules - Uses IV radioactive glucose preparation - Check blood glucose (high levels may interfere W/ test) - Food & fluids other than H2O may be restricted for 4-6 Hrs - Encourage fluids to excrete radioactive
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| Endoscopy Bronchoscopy Study | For Dx, biopsy specimen collection, assessment of changes, or suction mucous plugs - NPO 6-12 Hrs before test & until gag reflex returns - Biopsy > monitor for hemorrhage and pneumothorax
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