Pulmonary function test

During tiie ongoing assessment, tiie nurse assesses the respiratory status every 4 hours and whenever tiie drug is administered. The nurse notes the respiratory rate, lung sounds, and use of accessory muscles in breathing, hi addition, tiie nurse keeps a careful record of the intake and output and reports any imbalance, which may indicate a fluid overload or excessive diuresis. It is important to monitor any patient with a history of cardiovascular problems for chest pain and changes in the electrocardiogram. The primary health care provider may order periodic pulmonary function tests, particularly for patients with emphysema or bronchitis, to help monitor respiratory status. 

The Lung Clinical Physiology and Pulmonary Function Tests, Year Book, Chicago, 2nd ed., 1962. 

Spirometry, an objective measure of pulmonary function, can be used to assist in confirming the diagnosis of asthma. The primary pulmonary function tests used to assist in the diagnosis of asthma are the forced expiratory volume in... 

Use the patient s symptoms and pulmonary function tests to classify disease severity. 

A suspected diagnosis of COPD should be based on the patient s symptoms and/or history of exposure to risk factors. Spirometry is required to confirm the diagnosis. The presence of a postbronchodilator FEV,/FVC ratio less than 70% [the ratio of FEV, to forced vital capacity (FVC)] confirms the presence of airflow limitation that is not fully reversible.1,2 Spirometry results can further be used to classify COPD severity (Table 12-1). Full pulmonary function tests (PFTs) with lung volumes and diffusion capacity and arterial blood gases are not necessary to establish the diagnosis or severity of COPD. 

Pulmonary function tests (PFTs) indicate decreased forced expiratory volume in 1 second (FEN/,), decreased forced vital capacity (FVC), and increased residual volume. Values are typically worse during acute pulmonary exacerbations. 

Monitor for changes in pulmonary symptoms such as cough, sputum production, respiratory rate, and oxygen saturation. Symptoms of an acute exacerbation should improve with antibiotics and aggressive airway clearance therapy. Pulmonary function tests should be markedly increased after 1 week and trend back to pre-exacerbation levels after 2 weeks of therapy, ft improvement lags, 3 weeks of therapy may be needed. 

Lung Bronchiolitis obliterans diagnosed with lung biopsy Bronchiolitis obliterans diagnosed with pulmonary function tests and radiology0 Bronchiolitis obliterans organizing pneumonia... 

Spirometry Measurement of inhaled and exhaled volumes and flow rates of gas from the lungs. Pulmonary function tests obtained from spirometry are used to aid in the diagnosis of obstructive and restrictive airway diseases. 

Enright PL, Lebowitz MD, Cockroft DW. Physiologic measures pulmonary function tests. Asthma outcome. Am J Respir Crit Care Med 1994 149 S9-18 discussion S19-20. 

Mauderly, J. L. and Pickrell, J. A. (1973). Pulmonary function testing of unanesthetized beagle dogs, page 665 in Research Animals in Medicine, DHEW Publication No. (NIH) 72-333, Lowell, T. H., Ed. (National Heart and Lung Institute, National Institutes of Health, Washington). 

II6. A 32-year-old cancer patient, who has smoked two packs of cigarettes a day for 10 years, presents a decreased pulmonary function test. Physical examination and chest x-rays suggest preexisting pulmonary disease. Of the following drugs, which is best not prescribed ... 

Pulmonary function tests Decreased vital capacity Prolonged expiratory flow... 

In chronic stable COPD, pulmonary function tests should be assessed with any therapy addition, change in dose, or deletion of therapy. Other outcome measures include dyspnea score, quality-of-life assessments, and exacerbation rates (including emergency department visits and hospitalizations). 

Respiratory Effects. Pulmonary function tests were not affected in workers exposed to hexachloroethane for 5 weeks while wearing protective equipment (Selden et al. 1994). Acute exposure of rats to 5,900 ppm hexachloroethane (a combination of gaseous and microcrystalline material) resulted in interstitial pulmonary pneumonitis (Weeks et al. 1979). These pulmonary lesions were seen after a 14-day recovery period. The entrapment of solid hexachloroethane particles in the lungs could have contributed to the symptoms observed. 

O Neil, J.J. and Raub, J.A., Pulmonary function testing in small laboratory animals, Environ. Health Perspect., 56, 11-22, 1984. 

We still lack an adequate dose-response relationship for humans exposed to ozone, particularly at concentrations less than about 0.2 ppm. The data base for the development of such a relationship for both short-and long-term exposures is inadequate. Although some data from controlled studies are available for concentrations above 0.3 ppm, methods for extrapolating to lower concentrations are needed. Moreover, it is not clear how to weight the results of pulmonary function tests on humans, animal studies, and epidemiologic studies in a general dose-response relationship. 

The second study is only beginning and will attempt to correlate the effects of photochemical oxidants and cigarette-smoking in promoting chronic respiratory signs and symptoms in cohorts of adolescents and their families. Pulmonary function tests will be included. 

Kagawa and Toyama in Tokyo followed 20 normal 11-yr-old school children once a week from June to December 1972 with a battery of pulmonary-function tests. Environmental factors studied included oxidant, ozone, hydrocarbon, nitric oxide, nitrogen dioxide, sulfur dioxide, particles, temperature, and relative humidity. Temperature was found to be the most important environmental factor affecting respiratory tests. The observers noted that pulmonary-function tests of the upper airway were more susceptible to increased temperature than those of the lower airway. Although the effect of temperature was the most marked, ozone concentration was significantly associated with airway resistance and specific airway conductance. Increased ozone concentrations usually occur at the same time as increased temperature, so their relative contributions could not be determined. 

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