Adult Medical-Surgical Nursing Respiratory Module: Diagnostic Tests

Pulmonary Disease Common Clinical Manifestations:

Pulmonary Disease: Common Clinical Manifestations DyspnoeaOrthopnoeaTachypnoea Apnoea: (respiratory failure) Cough, dry or productive, haemoptysis Cyanosis: central/ peripheral Clubbing of nails: chronic O2 insufficiency Barrel chest (chronic exertion intercostals)

Altered Pattern of Respirations On physical examination: Stertorous respirations Cheyne-Stokes respirations Asymmetrical breathing WheezingStridor

Pulmonary Disease Common Diagnostic Tests:

Pulmonary Disease: Diagnosis Patient history and clinical picture Chest auscultation Laboratory analysis Xrays/ radiography Diagnostic procedures

Diagnosis: Clinical Picture Physical examination: Breathing pattern Symmetry in breathing Degree of dyspnoea Presence of cyanosis Clubbing of finger nails Presence of barrel chest

Chest Auscultation Air entry Adventitious sounds: Râles/ crackles: discreet (not continuous) which indicate fluid in the alveoli Hyper-resonance: air trapped in alveoli (bronchospasm) Wheezes: continuous sounds, especially on expiration indicate bronchospasm

Laboratory Analysis Sputum: Culture: micro-organisms, culture and sensitivity Acid-fast bacilli (AFB): Tuberculosis (TB) Throat swab culture Arterial blood gasses (ABG) CBC

Pulmonary Function Tests Forced Vital Capacity (“Peak Flow”): the maximal volume expired after maximal inspiration (best of 3) Forced Expiratory Volume in 1 second (FEV1) as a ratio of Forced Vital Capacity (FVC) Pulse oximetry

Diagnostic Xrays/ Scans Chest Xray (AP/ lateral) CT scan (computerised tomogram) MRI (magnetic resonance imaging) Fluoroscopy: Pulmonary angiography (to diagnose Pulmonary Embolism) Lung scan using isotopes

Diagnostic Procedures: Bronchoscopy A flexible, fibre-optic scope with a light used for: Examination (under sedation/ anaesthetic) Removal of foreign body/ secretions Tissue biopsy Sample of secretions for histology/ culture

Diagnostic Procedures: Chest Aspiration Performed to: Drain pleural effusion and expand lung Analyse aspirated fluid: CytologyCulture