NR 507 Week 3 Assignment; Alterations in Pulmonary Function.

Measure Definition Maneuver Forced Vital The FVC measures the Pa琀椀ent inhales as deep as possible and then Capacity (FVC); volume of air in the lungs exhales as long and as forcefully as possible. Normal 80-120% that can be exhaled. Forced Expiratory Amount of air forcefully The pa琀椀ent inhales and forcefully exhales as Volume in 1 exhaled from the lungs in the fast as possible. second (FEV1); 昀椀rst second. Normal 80- 120% Determines if the pa琀琀ern is This is a calculated ra琀椀o that represents the FEV1/FVC ra琀椀o obstruc琀椀ve, restric琀椀ve or propor琀椀on of a person's vital capacity that they normal are able to expire in the 昀椀rst second of forced expira琀椀on to the full, forced vital capacity. Di昀昀using capacity: The di昀昀using capacity is simply how well the lungs are able to exchange gas. Gas exchange is most e昀케cient 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 condi琀椀on that decreases the pa琀椀ent’s di昀昀using capacity because of a loss of surface area is emphysema. Condi琀椀ons that increase the lungs thickness can also decrease di昀昀using capacity as in the case of pulmonary 昀椀brosis. Residual volume (RV) and Total Lung Capacity (TLC): RV is the amount of air that remains in the lungs a昀琀er a forceful exhala琀椀on. RV + FVC = TLC. Note that the RV cannot be measured by spirometry. Other methods are used that require the pa琀椀ent to inhale an inert gas (helium) or sit in an air琀椀ght booth where the pressure is measured during breathing. These measurements are also called sta琀椀c lung volumes. The values add to the informa琀椀on obtained from spirometry. If the pa琀椀ent has an obstruc琀椀ve disease, RV and TLC results will be elevated which reveals air trapping and hyperin昀氀a琀椀on. In restric琀椀ve disease, the TLC is needed to con昀椀rm true restric琀椀on. It can also help in quan琀椀fying the degree of restric琀椀on. Steps to Analyze Pulmonary Func琀椀on 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 popula琀椀on studies using individuals without lung disease. Each pa琀椀ent’s predicted values depend on the age, height, and gender. This informa琀椀on is entered into a computer prior to the PFT. Once the results have been received, the NP looks at two factors: 1) the pa琀琀ern of the condi琀椀on; 2) severity of the condi琀椀on. Step 1: Determine the Pa琀琀ern In order to classify the respiratory issue as either obstruc琀椀ve, restric琀椀ve or normal., the NP starts by looking at the FEV1/FVC ra琀椀o. Obstruc琀椀ve pa琀琀ern: If the FEV1/FVC ra琀椀o is less than 70% or less than the lower limit of normal for the pa琀椀ent. FEV1 also falls to a greater degree than the FVC. Restric琀椀ve pa琀琀ern: If the FEV1/FVC ra琀椀o is greater than 70% or greater than the lower limit of normal, then the spirometry test is either normal, or a restric琀椀ve respiratory abnormality