n w 6 part 2

Name of Test

Test Type

Normal Adult Findings

Indications for Test

Interfering Factors

Clinical Significance of Findings

Chest Xray

Fluoroscopy

X-ray study

Normal lungs and surrounding structures

To better identify and diagnose structures in the lungs, diaphragm, or heart.

Pregnancy

Conditions that affect patient’s ability to take and hold a deep breath, lung scarring, obesity

Metal or metal components that can obstruct findings

It allows real time moving images to properly diagnose findings.

Example: to separate a pulmonary nodule from a prominent breast nipple

Ventilation – Perfusion Scan

Nuclear Scanning

Diffuse and homogenous uptake of nuclear material by the lungs

To diagnose a pulmonary embolism (PE)

Performed on patients with noncardiac chest pain, shortness of breath, tachycardia

Patients with known pulmonary parenchymal or pleural problems can alter the results

Pregnancy

Evidence of a pulmonary embolism = will read as a ventilation/perfusion mismatch

Other pulmonary conditions such as pneumonia, TB, COPD, or tumor

Bronchoscopy

Thoracentesis

Pulmonary

Function

Tests & Spirometry

Spirometry is performed first

Based on age, height, wait, race, and sex, normal values for volumes and flow rates can be predicted. Values greater than 80% of predicted values are considered normal.

To detect abnormalities in respiratory function and to determine the extent of pulmonary abnormality. Specifically, spirometry provides information about obstruction or restriction of airflow and supports the diagnosis of COPD and chronic restrictive pulmonary disease.

Contraindications: Patients who are in pain, because of the inability for deep inspiration an expiration. Patients who are unable to cooperate because of age or mental incapability.

A spirometer is a machine that can measure air volumes. Spirometry is the standard method for measuring most relative lung volume; however, it is incapable of providing information about absolute volumes of air in the lung.

Tuberculin Skin Test

Sputum Culture

Arterial Blood Gas

Magnetic Resonance Imaging

Radiology

Considered normal if the structures being examined are normal in appearance.

To evaluate abnormalities of the multiple organs, bones, joints extremities, soft tissues and spinal cord

A major disadvantage of MRI is that patient eligibility is reduced. For example, examination of patients requiring cardiac monitoring or having metal implants, metal joint replacements, pens for open reduction of fractures, pacemakers, or cerebral aneurysm clips will result in image degradation and may endanger the patient.

Can provide information between normal tissue and pathologic tissue and provide a natural contrast between blood vessels and other tissues. MRI is helpful in the evaluation of the following areas: Head and surrounding structures, spinal cord and surrounding structures, face, neck, mediastinum, heart and great vessels, liver and biliary tree, kidney, prostate, bones and joints, breast, extremities and soft tissues, and pancreas

Computed Tomography

Radiology

Considered normal if the organs and structures being examined are normal in appearance.

To evaluate the tracheobronchial tree, and the pulmonary system as a whole to evaluate suspected disease.

Questionable or vague abnormalities on routine chest x-ray

Patient-based artifacts on the CT scan are caused by patient movement.

Reaction to contrast dye, contrast given through an IV may cause a slight burning feeling, a metallic taste in the mouth, and a warm flushing of the body

Pregnancy & breastfeeding

Can provide information regarding Lung, Heart, Chest Wall, Diaphragm, or Mediastinum and conditions that may occur with each of these areas

Acid-Fast Bacilli Smear

Microscopic Study

No bacilli seen

Any patient with a persistent productive cough, night sweats, anorexia, weight loss, fever, hemoptysis, or abnormal chest x-ray

False negatives can occur with faulty laboratory techniques

False positive can occur when water suspending the smear contains a non-TB organism

This is used to support the diagnosis of and monitor the treatment of TB.

The AFB smear supports the diagnosis of TB, but a definitive diagnosis requires a sputum culture and sensitivity

If a patient is suspected of TB, the nurse should wear an N95 respirator mask and the patient should be placed on isolation

Pulse Oximetry