Respiratory System Diagnostic Tests and Labs

Arterial Blood Gases (ABGs)

• Assesses acid-base balance and oxygenation in critical-care patients and those with acute/chronic respiratory disorders.
• Key Components of ABGs:
  • pH: 7.35 - 7.45
  • PaCO2 (partial pressure of carbon dioxide): 35 - 45
  • HCO3 (bicarbonate): 22 - 26
  • PaO2 (partial pressure of oxygen): 80 - 100
  • SaO2 (oxygen saturation of arterial blood): 95% - 100%

Pulse Oximetry

• Measures SpO2, which should be 95% - 100%.
• Note: Patients with COPD may have SpO2 levels in the low 90s.

Pulmonary Function Tests (PFTs)

• Useful for diagnosing asthma and COPD.

Bronchoscopy

• Involves inserting a tube into the airway for visualization and specimen collection.
• Pre-procedure Care:
  • Ensure patient is NPO (nothing by mouth) for 4-8 hours.
  • Administer prescribed sedation medications.
• Post-procedure Care:
  • Confirm return of gag reflex before allowing food/drink.
  • Teach that sore, dry throat, and blood-tinged mucus are expected.
  • Monitor for complications, e.g., pneumothorax.

Thoracentesis

• Involves needle insertion into posterior chest to remove fluid/air from pleural space.
• Pre-procedure Care:
  • Position patient upright with arms supported on bedside table or pillows.
  • Advise patient to remain still and not talk, move, or cough.
• Post-procedure Care:
  • Monitor for complications like pneumothorax, bleeding, hypotension.
  • Consider chest x-ray if complications suspected.
  • Advise deep breathing to expand lungs.

Quiz Questions

1. True or False: An SpO2 of 90% is expected in a patient with COPD.
   • Answer: True
2. Assessment before eating/drinking post-bronchoscopy?
   • Answer: Ensure gag reflex has returned.
3. Positioning for thoracentesis?
   • Answer: Sit upright with arms supported on bedside table or pillows.

Conclusion

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