LAB AND DIAGNOSTICS (OXYGENATION) Flashcards by michaela gail

functions of lab and diagnostics

confirm diagnosis
rule out others
evaluate treatment

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Procedures that involve entering the body (through skin, mucosa, or insertion into a body cavity).

invasive

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Procedures that do not break the skin or enter body cavities.

non-invasive

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A test that examines mucus coughed up from the lungs to detect infection, inflammation, or abnormal cells in the respiratory tract.

sputum analysis

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identify the meaning of these sputum colors:

green
yellow
white
clear
rust
red
pink

pseudomonas
bacterial
viral
allergy
lung cancer
blood
pulmonary edema

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A test that identifies bacteria in a sample (Gram stain), grows them (culture), and determines which antibiotics can effectively kill them (sensitivity).

gram’s stain culture and sensitivity

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checks if PTB is still infectious

acid-fast bacili

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The study and examination of individual cells to detect diseases such as infections, inflammation, or cancer.

cytology

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when to collect sputum

early morning

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how many hours are sputum viable

2 hours

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contents of sputum label

name, DOB, time taken

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implications of ___ in getting sputum:

immunosuppressives
antibiotics

immuno - may have lots of bacteria
antibiotics - may have lower no. of bacteria

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how to do DB and coughing

3 deep breaths + 1 forceful cough

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purpose of nebulization with hypertonic / saline

liquify mucus and stimulate coughing

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in suctioning which goes first?

trach before oral (clean to dirty)

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A procedure where a flexible tube is inserted into the airways to suction out mucus or secretions for relief or examination.

bronchoscopic removal

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chest physiotherapy is contraindicated in

hemoptysis

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what are the various methods of obtaining sputum

DB and coughing
nebulization
tracheal suction
bronchoscopic removal
gastric aspiration
transtracheal aspiration

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AFB specimen must be taken for ___ consecutive days

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what type of container?

AFB
GSCS

clean
sterile

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2/3 or 3/3 (+) in sputum

smear (+) / infectious

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1/3 (+) in sputum

doubtful, repeat test

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3/3 (-) in sputum

smear (-) / negative

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An imaging test that uses X-rays to visualize the lungs, heart, and chest structures to detect diseases or abnormalities.

chest xray

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used to cover the body you dont want to be exposed to radiation e.g. pregnant women

lead apron

A series of breathing tests that measure how well the lungs take in and release air and how efficiently they transfer oxygen. - done after surgery to check if recovered from anesthesia

pulmonary function test

A device used to measure the amount and speed of air a person inhales and exhales during breathing tests.

spirometer

pulmonary function test is usually done by

respiratory therapist

as a nurse, what should you do before sending the pt to a respiratory therapist for PFT

practice how to do deep breathing and coughing, advise not to smoke, hold medications

A questionnaire used to measure the level of a person’s nicotine dependence or addiction to smoking. - for nicotine replacement therapy

fagerstrom test

fagerstrom test: 5-6 points

heavy nicotine dependence 21 mg nicotine patch

fagerstrom test: 3-4 points

moderate nicotine dependence 14 mg nicotine patch

fagerstrom test: 0-2 points

light nicotine dependence 7 mg nicotine patch / no patch

A non-invasive test that measures the oxygen saturation level of the blood using a sensor placed on the skin, usually the fingertip.

pulse oximetry

- decreased tissue perfusion - normal o2 sa blood - 90-94%

hypoxia

- decreased o2 sa blood - < 90%

hypoxemia

A test that records the electrical activity of the heart to detect rhythm problems or heart abnormalities.

electrocardiogram

- U wave - depressed ST - short T wave

hypokalemia

- prolonged QRS - elevated ST - peaked T wave

hyperkalemia

- elevated ST segment - inverted T wave - pathologic Q wave

myocardial infarction

A portable device worn for 24–48 hours to continuously record the heart’s electrical activity during normal daily activities.

holter monitoring

An ultrasound test that creates moving images of the heart to assess its structure and how well it’s pumping blood.

echocardiogram

A procedure that evaluates how the heart performs under physical stress, usually through exercise or medication.

stress test

Uses medication to mimic the effects of exercise on the heart for patients unable to exercise.

pharmacologic ST

Involves exercising, usually on a treadmill or bike, to assess the heart’s response to activity.

physical ST

Evaluates how psychological stress affects heart rate, blood pressure, and overall cardiac function. - usually given a math test

mental ST

nursing considerations for stress test

- no coffee - get enough sleep - stop vasodilators - wear loose clothing

A test that examines the appearance, concentration, and content of urine to detect diseases or monitor health conditions. - effects of cardiovascular disease on renal function

urinalysis

indications of the ff: albuminuria myoglobinuria

long standing HTN myocardial infection

A substance used in the tuberculin skin test to check if a person has been exposed to the bacteria that cause tuberculosis. - test if exposed to TB

purified protein derivatives

PPD is read after

48-72 hours (most accurate = 72 hours)

PPD: 0-4 mm > 5 mm > 10 mm

not significant MAY be significant in indv. who are at risk significant in indv. who have normal or mildly impaired immunity

PPD: > 15 mm > 10 mm

significant in general public w/o risk factors significant in health care workers, iv drug abusers, medically underserved popu

how many mm is PPD significant for pts with HIV or those who had recent close contact with active TB

> 5 mm

A blood test that measures oxygen, carbon dioxide, and pH levels to assess how well the lungs and kidneys maintain acid-base balance.

arterial blood gas

A procedure where a thin tube with a camera is inserted into the airways to view the lungs, collect samples, or remove blockages.

bronchoscopy

possible complications of bronchoscopy

- reaction to local anes - infection - aspiration - bronchospasm - hypoxemia - bleeding, perforation

how many hours NPO before bronchoscopy

6 hours

pre-op meds for bronchoscopy

atropine, opioids, sedatives

purpose: atropine opioids sedatives

decrease mucus secretions / counteract vasovagal attack by increasing HR analgesic induces sleep

nursing considerations for bronchoscopy

- side lying - check gag reflex - WOF complication

A procedure where a needle is inserted into the pleural space to remove fluid for testing or to relieve pressure on the lungs.

thoracentesis

site of insertion in thoracentesis

2nd or 3rd ICS - air 8th or 9th ICS - fluid

during thoracentesis, instruct patient to ___ during insertion of needle

hold breath

post-thoracentesis: assess for ___

respiratory distress

An imaging test that uses contrast dye and X-rays to visualize the blood vessels of the lungs and detect blockages or abnormalities.

pulmonary angiography

nursing considerations pre-angiography - NPO ___ - hold ___ - assess for ____

post midnight anticoagulant drugs iodine allergy

nursing considerations intra-angiography - have ___, ___, ___ ready during procedure

o2, antispasmodic, corticosteroids

nursing considerations post-angiography - position ___ - care for ___ - wof ___

flat on bed catheter site complications

A blood test that measures red cells, white cells, and platelets to assess overall health and detect disorders like infection or anemia.

cbc

normal values WBC RBC

4.5-11 mil/ml Male: 4-4-5.8 mil/ml Female: 3.9-5.3 mil/ml

normal values HgB

Male: 13.5-16.5 g/dl Female: 12-15 g/dl

normal values HCT

Male: 41-50% Female: 36-44%

normal values platelets

100-450 x 10^3/ul

A blood test that measures how quickly red blood cells settle at the bottom of a tube, helping detect inflammation in the body.

erythrocyte sedimentation rate

normal ESR

Male: 15-20 mm/hr Female: 20-30 mm/hr

- required for clotting - effectiveness of coumadin therapy - when mag start ang clot - when your body decides to heal

prothrombin time

- best single screening test for disorder of coagulation - effectiveness of heparin

partial thromboplastin time

normal range PT PTT

11-16 secs 60-70 secs

- same purpose of PTT - most specific to evaluate effectiveness of heparin

activated partial thromboplastin time

normal range APTT

30-45 secs

A test that standardizes prothrombin time results to monitor blood-thinning therapy, especially with warfarin.

international normalized ratio

tests for renal function (2)

BUN, creatinine

normal range BUN creatinine

10-20 mg/dl 0.6-1.3 mg/dl

- hormone synthesis and cell membrane formation - brain and nerve tissues - preparation NPO 10-12 hours

cholesterol

normal cholesterol

150-200 mg/dl

- stored in adipose tissue - source of energy - increased after meal, stress, DM, alcohol intake, obesity - preparation NPO 10-12 hours

triglycerides

normal range triglycerides

140-200 mg/dl

- cholesterol and triglycerides into cell - CAD

LDL

- cholesterol away from cell and tissue - liver for excretion

HDL

normal range LDL HDL

less than 1300 mg/dl 35-65 mg/dl

- SGOT (serum glutamic-oxaloacetic transaminase) - elevated = tissue necrosis

aspartate aminotransferase (AST)

normal range AST

7-40 mu/ml

AST during MI elevation peaks return to normal

4-6 hours 24-36 hours 4-7 days

- cardiac specific enzymes - first enzyme level to rise - accurate indicator for MI

creatinine phosphokinase (CK-MB)

normal range CK-MB

Male: 50-325 mu/ml Female: 50-250 mu/ml

CK-MB during MI onset peaks return to normal

3-6 hours 12-18 hours 3-4 days

- found only in cardiac muscle - A protein released into the blood when the heart muscle is damaged; used to diagnose heart attacks. - normal: 0-0.04 mg/ml

troponin I

troponin I during MI onset peaks return to normal

3-4 hours 4-28 hours 1-3 weeks

- delayed seeking medical attention - An enzyme found in many body tissues; elevated levels can indicate tissue damage, such as in the heart, liver, or muscles.

lactic dehydrogenase (LDH)

normal range LDH

100-225 mu/ml

LDH during MI onset peaks return to normal

12 hours 48 hours 10-14 days

Measures pressure in the right atrium, reflecting blood volume and venous return to the heart.

central venous pressure

Measures pressure in the pulmonary artery to assess lung circulation and right heart function.

pulmonary artery pressure

normal range CVP PAP

5-12 mmHg 4-12 mmHg

nursing considerations during hemodynamic monitoring - inflate balloon only for ___ readings, deflate between readings - observe cath site, culture every ___ hours - assess extremity for ___, ___, ___, and ___

PCWP (Pulmonary capillary wedge pressure) 48 hours color, temp, capillary filling, sensation

- involves introduction of contrast medium into the vascular system to outline the heart and blood vessels - may be done during cardiac catheterization

angiography / arteriography

angiogram: observe for ___ after procedure bc the contrast may cause profound diuretic effect

hypotension

LAB AND DIAGNOSTICS (OXYGENATION) Flashcards

(108 cards)