NR 507 PULMONARY SYSTEM & FUNCTION FINAL EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

1. Visit this site for case examples on Pulmonary Function Testing Case Questions and Answers: - 2. Abbreviations Correct Answer -FVC / Forced Vital Capacity -FEV1 / Forced Expiratory Volume in One Second -TLC / Total Lung Capacity -RV / Residual Volume -DLCO / Diffusion Capacity for Carbon Monoxide -BD / Bronchodilator 3. Mechanics of Respiration: Pulmonary Function Tests: Pulmonary function tests (PFTs) are non-invasive tests that provide information about lung function. PFTs alone cannot differentiate among the causes of respiratory abnormalities. Therefore, the patient's history, physical exam and other diagnostics must be considered when making a diagnosis. The PFT can help the NP determine the patient's respiratory pattern, specifically if the abnormality is due to an obstructive or restrictive problem. Once the pattern is identified, PFTs allow the NP to determine the severity of the disease. This data combined with other patient findings, leads to a diagnosis. 4. There are some indications to help the NP to determine when to order PFTs Correct Answer 1. When signs and symptoms of a respiratory problem require evaluation (cough, dyspnea, cyanosis, wheezing, hypoxemia, hypercapnia, and lung hyperinflation). 2. When disease progression needs to be determined. 3. When monitoring the effectiveness of drug therapy. 4. When monitoring for potential toxic effects of certain drugs. 5. Components of a Pulmonary Function Tests Spirometry: Spirometry: This measures air movement in and out of the lungs during various respiratory maneuvers. The NP can also determine how much air the patient is breathing in and out and how fast the patient is doing it. Think about the respiratory cycle in terms of lung volume and lung capacities. The capacity is just simply the sum of one of more volumes. There are three important measures on which the NP focuses when reviewing spirometry results: 6. There are three important measures on which the NP focuses when reviewing spirometry results: 1.) FVC: Measure Forced Vital Capacity (FVC); Normal 80-120% Definition The FVC measures the volume of air in the lungs that can be exhaled. Maneuver Patient inhales as deep as possible and then exhales as long and as forcefully as possible. 7. There are three important measures on which the NP focuses when reviewing spirometry results: 2.) FEV1: Measure Forced Expiratory Volume in 1 second (FEV1); Normal 80-120% Definition Amount of air forcefully exhaled from the lungs in the first second. Maneuver The patient inhales and forcefully exhales as fast as possible. 8. There are three important measures on which the NP focuses when reviewing spirometry results: 3.) FEV1/FVC ratio: Measure FEV1/FVC ratio Definition Determines if the pattern is obstructive, restrictive or normal Maneuver This is a calculated ratio that represents the proportion of a person's vital capacity that they are able to expire in the first second of forced expiration to the full, forced vital capacity. 9. Components of a Pulmonary Function Tests: Diffusing capacity: The diffusing capacity is simply how well the lungs are able to exchange gas. Gas exchange is most efficient in a lung that has high surface area because it's easier for the blood to pick up the gas that's being exchange. An example of a condition that decreases the patient's diffusing capacity because of a loss of surface area is emphysema. Conditions that increase the lungs thickness can also decrease diffusing capacity as in the case of pulmonary fibrosis. 10. Components of a Pulmonary Function Tests: Residual volume (RV) and Total Lung Capacity (TLC) RV + FVC = TLC: RV is the amount of air that remains in the lungs after a forceful exhalation. RV + FVC = TLC. Note that the RV cannot be measured by spirometry. Other methods are used that require the patient to inhale an inert gas (helium) or sit in an airtight booth where the pressure is measured during breathing. These measurements are also called static lung volumes. The values add to the information obtained from spirometry. If the patient has an obstructive disease, RV and TLC results will be elevated which reveals air trapping and hyperinflation. In restrictive disease, the TLC is needed to confirm true restriction. It can also help in quantifying the degree of restriction. 11. Steps to Analyze Pulmonary Function Tests (PFTs): First, the NP must understand how the results of the PFT is delivered. The results will yield measured values and percentages of predicted values. Predicted values and lower limits of normal have been standardized by population studies using individuals without lung disease. Each patient's predicted values depend on the age, height, and gender. This information is entered into a computer prior to the PFT. Once the results have been received, the NP looks at two factors: 1) the pattern of the condition; 2) severity of the condition. 12. Step 1 - Determine the pattern: In order to classify the respiratory issue as either obstructive, restrictive or normal., the NP starts by looking at the FEV1/FVC ratio. Obstructive pattern: If the FEV1/FVC ratio is "less than 70%" or less than the lower limit of normal for the patient. FEV1 also falls to a greater degree than the FVC. Restrictive pattern: If the FEV1/FVC ratio is "greater than 70%" or greater than the lower limit of normal, then the spirometry test is either normal, or a restrictive respiratory abnormality is present. To make this distinction, the NP must look at the TLC. In restrictive disorders, the percent predicted of TLC is <80%, where 80-120% represents a normal range. 13. Measurement: Forced vital capacity (FVC): Obstructive -Decreased or normal