100% found this document useful (1 vote)
190 views10 pages

Notes

ghk

Uploaded by

Vu Hau
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
100% found this document useful (1 vote)
190 views10 pages

Notes

ghk

Uploaded by

Vu Hau
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 10

2249_FM_ii-vi.

qxd 8/11/09 6:22 PM Page iii

PFT
Notes
Pulmonary Function Testing Pocket Guide

Gary C. White, MEd, RRT, RPFT

Purchase additional copies of this book


at your health science bookstore or directly
from F. A. Davis by shopping online at
www.fadavis.com or by calling 800-323-3555
(US) or 800-665-1148 (CAN)

A Daviss Notes Book


2249_FM_ii-vi.qxd 8/11/09 6:22 PM Page iv

F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com

Copyright 2010 by F. A. Davis Company

All rights reserved. This product is protected by copyright. No part of it may be


reproduced, stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise, without
written permission from the publisher.

Printed in China by Imago

Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1

Senior Acquisitions Editor: T. Quincy McDonald


Developmental Editor: Keith Donnellan
Manager of Content Development: George Lang
Art and Design Manager: Carolyn OBrien
Reviewers: John Rutkowski, MBA, MPA, FACHE, RRT; Robert Tralongo, MBA, RT,
RRT-NPS, CPFT, AE-S

As new scientific information becomes available through basic and clinical research,
recommended treatments and drug therapies undergo changes. The author(s) and
publisher have done everything possible to make this book accurate, up to date, and
in accord with accepted standards at the time of publication. The author(s), editors,
and publisher are not responsible for errors or omissions or for consequences from
application of the book, and make no warranty, expressed or implied, in regard to
the contents of the book. Any practice described in this book should be applied by
the reader in accordance with professional standards of care used in regard to the
unique circumstances that may apply in each situation. The reader is advised always
to check product information (package inserts) for changes and new information
regarding dose and contraindications before administering any drug. Caution is
especially urged when using new or infrequently ordered drugs.

Authorization to photocopy items for internal or personal use, or the internal or per-
sonal use of specific clients, is granted by F. A. Davis Company for users registered
with the Copyright Clearance Center (CCC) Transactional Reporting Service, provid-
ed that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive,
Danvers, MA 01923. For those organizations that have been granted a photocopy
license by CCC, a separate system of payment has been arranged. The fee code for
users of the Transactional Reporting Service is: 8036-2249-4/10 0 + $.25.
2249_FM_ii-vi.qxd 8/11/09 6:22 PM Page v

Place 278 x 278 Sticky Notes here


for a convenient and refillable note pad

HIPAA Compliant
OSHA Compliant

Waterproof and Reusable


Wipe-Free Pages

Write directly onto any page of PFT Notes


with a ballpoint pen. Wipe old entries off
with an alcohol pad and reuse.

SPIROM- LUNG DIFFUS SPEC BLOOD NORM


BASICS TOOLS
ETRY VOLS DISTR PROC GASES QA
2249_FM_ii-vi.qxd 8/11/09 6:22 PM Page vi

Look for our other Daviss Notes


titles available now!

Respiratory Notes: Respiratory Assess Notes: Assessment


Therapists Pocket Guide and Diagnostic Reasoning
ISBN-13: 978-0-8036-1467-3 ISBN-13: 978-0-8036-1749-0
ECG Notes: Interpretation and DocuNotes: Nurses Clinical
Management Guide Pocket Guide to Effective
ISBN-13: 978-0-8036-1347-8 Documenting and Reporting
EMS Notes: EMT & Paramedic ISBN-13: 978-0-8036-2092-6
Field Guide MedSurg Notes: Nurses
ISBN-13: 978-0-8036-2038-4 Clinical Pocket Guide,
LabNotes: Guide to Lab & 2nd edition
Diagnostic Tests, 2nd edition ISBN-13: 978-0-8036-1868-8
ISBN-13: 978-0-8036-2138-1 NCLEX-RN Notes: Core
Critical Care Notes: Clinical Review & Exam Prep
Pocket Guide ISBN-13: 978-0-8036-1570-0
ISBN-13: 978-0-8036-2084-1 NutriNotes: Nutrition & Diet
MedNotes: Nurses Therapy Pocket Guide
Pharmacology Pocket Guide, ISBN-13: 978-0-8036-1114-6
3rd Edition Coding Notes: Medical
ISBN-13: 978-0-8036-2139-8 Insurance Pocket Guide
IV Med Notes: IV Administration ISBN-13: 978-0-8036-1493-2
Pocket Guide PsychNotes: Clinical Pocket
ISBN-13: 978-0-8036-1446-8 Guide, 2nd edition
IV Therapy Notes: Nurses ISBN-13: 978-0-8036-1853-4
Clinical Pocket Guide
ISBN-13: 978-0-8036-1288-4

For a complete list of Daviss Notes and


other titles for health care providers,
visit www.fadavis.com.
2249_Tab2_015-049.qxd 8/11/09 6:20 PM Page 15

15
Indications for Spirometry
AARC Clinical Practice
ATS: Standardization of Guidelines: Spirometry 1996
Spirometry, 2005 Revision and Update
Diagnostic
Evaluate symptoms, signs, or Detect absence or presence of
abnormal laboratory tests. lung dysfunction suggested
Measure the effect of disease by history or physical signs
on pulmonary function. and symptoms and/or the
Assess risk for pulmonary presence of other abnormal
disease. diagnostic tests (e.g., chest
Assess preoperative risk. radiograph, analysis of arterial
Assess prognosis. blood gases).
Assess heath status before Quantify the severity of known
beginning strenuous physical lung disease.
activity programs.
Assess therapeutic Assess the change in lung
intervention. function over time or follow-
Describe the course of ing administration of or
diseases that affect lung change in therapy.
function. Assess the potential effects or
Monitor people exposed to response to environmental or
injurious agents. occupational exposure.
Monitor for adverse reactions
to drugs with known pul-
monary toxicity.
Disability/Impairment Evaluations
Assess patients as a part of a Assess the risk for surgical
rehabilitation program. procedures known to affect
Assess risks as part of an lung function.
insurance evaluation.
Assess individuals for legal
reasons.

Continued

SPIROM-
ETRY
2249_Tab2_015-049.qxd 8/11/09 6:20 PM Page 29

29
Significance
Decreased PEF
Poor effort
Obstructive diseases
Portable Peak Flow Monitoring
Portable peak flow meters may be used by patients in the home
setting to monitor asthma symptoms. The equipment and tech-
nique is easily taught and self-performed by the patient. A Zone
system is recommended to assist the patient in monitoring his/her
symptoms.

Zone System for Peak Expiratory Flow


Monitoring

Zone Range Action


Green 80%100% of Continue therapy
personal best
Yellow 50%80% of An acute exacerbation may be
personal best occurring. Consider increasing
medication dose/frequency.
Red <50% of personal Take bronchodilator(s) immediately
best and notify healthcare provider

SPIROM-
ETRY
2249_Tab3_050-074.qxd 8/11/09 6:20 PM Page 57

57
Changes With Disease
Obstructive Disease Pattern
N2
80

60

40

20

0
0 2 4 6 8
Volume (L)

Restrictive Disease Pattern


N2
80

60

40

20

0
0 2 4 6 8
Volume (L)

LUNG
VOLS
2249_Tab3_050-074.qxd 8/11/09 6:20 PM Page 60

LUNG
VOLS

Helium Dilution
Perform volume/flow calibration

No Calibration
3.5% or 65 mL?

Yes

1. Add He to spirometer and start mixing fan


2. Calibrate He analyzer

1. Connect subject to spirometer with a


scuba mouthpiece and nose clips
2. Allow subject to tidal breathe room air
through the free-breathing valve

1. At resting FRC, switch the subject into the system


allowing the subject to re-breathe He mixture
2. Begin monitoring exhaled He concentration
3. Adjust O2 flow to obtain stable baseline

1. Subject continues to re-breathe He mixture


2. Monitor He concentration every 15 seconds
3. Toward end of study, have subject perform
an SVC maneuver

1. End of test criteria met


No He < 0.02% Yes 2. Wait for at least the time
over 30 seconds of the equilibration or 5
minutes between tests

Obtain two tests with FRC


10% of one another

60
2249_Tab4_075-093.qxd 8/11/09 6:21 PM Page 82

DIFFUS
DISTR

Calculating Breath-Hold Time


Breath-hold time is very important in the calculation of DLCO
(denominator of the DLCO equation). When more time is allowed
for gas equilibration, more CO will be bound to hemoglobin (Hb).
Both inhalation and exhalation take several seconds, during
which Hb is in contact with CO. Therefore, this time must be
accounted for in calculating breath-hold time. The American
Thoracic Society and the American Association for Respiratory
Care recommend using the Jones-Meade technique for calculat-
ing breath-hold time.
Jones-Meade Technique
Start of inspiration begins at 0.30 seconds after the start of
inspiration (includes 70% of inspiratory time).
End of the breath occurs at the 0.50-second point during
exhalation (includes 50% of expiratory time).

Inspiration Breathholding Expiration


6 Dead space
tl TLC washout
5 Sample
collection
4 V1
Volume (L)

2
Jones
1 0.3 t l
RV
0

0 2 4 6 8 10 1 1
Time (s)

82
2249_Tab4_075-093.qxd 8/11/09 6:21 PM Page 93

93
Total Lung Capacity (TLC) Determination
Total lung capacity (TLC) may be determined by integrating the
area under the exhaled N2 curve. This may be done by planimetry
or by the computer-based system integrating the area electroni-
cally. Residual volume (RV) is then determined by subtracting the
vital capacity (VC) from the TLC.

Acceptability Criteria
Mean expiratory flow rate must be <0.5 L/second.
After 500 mL, expiratory flows must not exceed 0.7 L/second
for more than 300 mL.
Inspiratory and expiratory VCs must be plus or minus 5% or
200 mL.
Cardiac oscillations must be minimal; to minimize cardiac
oscillations, increase expiratory flows (but not greater than
0.5 L/second).

Reproducibility Criteria
Tests meet acceptability criteria.
Expiratory VCs are 5% or 200 mL.
CV and CC 10%.

DIFFUS
DISTR

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy