PULM

ONARY

FUNCTI

ON TEST

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PULMONARY FUNCTION TESTPulmonary function tests are a group of tests that measure how well the lungs take in and release air and how well they move gases such as oxygen from the atmosphere into the body's circulation.

The test is performed through:

Spirometry test- The client breathes into a mouthpiece that is connected to an

instrument called a spirometer. The spirometer records the amount and the rate of air that you breathe in and out over a period of time.

For some of the test measurements, the client can breathe normally and quietly. Other tests require forced inhalation or exhalation after a deep breath.

PULMONARY FUNCTION TEST

Lung volume measurement can be done in two ways:

The most accurate way is to sit in a sealed, clear box that looks like a telephone booth (body plethysmograph) while breathing in and out into a mouthpiece. Changes in pressure inside the box help determine the lung volume.

Lung volume can also be measured when you breathe nitrogen or helium gas through a tube for a certain period of time. The concentration of the gas in a chamber attached to the tube is measured to estimate the lung volume.

PULMONARY FUNCTION TEST

To measure diffusion capacity: The client breathes a harmless gas for a very short time,

often one breath. The concentration of the gas in the air you breathe out is measured. The difference in the amount of gas inhaled and exhaled measures how effectively gas travels from the lungs into the blood.

To prepare for the test: Do not eat a heavy meal before the test. Do not smoke for 4 - 6 hours before the test. You'll get

specific instructions if you need to stop using bronchodilators or inhaler medications. You may have to breathe in medication before the test.

* Since the test involves some forced breathing and rapid breathing, you may have some temporary shortness of breath or lightheadedness. You breathe through a tight-fitting mouthpiece, and you'll have nose clips.

PULMONARY FUNCTION TEST

Objectives:

Diagnose certain types of lung disease (especially asthma, bronchitis and emphysema)

Find the cause of shortness of breath Measure whether exposure to contaminants at work affects

lung function Assess the effect of medication Measure progress in disease treatment

Abnormal: less than 80 %(indicates chest or lung disease) Contraindicated to those who have recent heart attack or

any heart-related problems

SPUTU

M CULT

URE

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SPUTUM CULTURE

A sputum culture is a test to detect and identify bacteria or fungi(plural of fungus) that are infecting the lungs or breathing passages.

“Sputum” is a thick fluid produced in the lungs and in the airways leading to the lungs.

A sample of sputum is placed in a container with substances that promote the growth of bacteria or fungi.

If no bacteria or fungi grow, the culture is negative. If organisms that can cause infection (pathogenic organisms) grow, the culture is positive. The type of bacterium or fungus will be identified with a microscope or by chemical tests.

SPUTUM CULTURE

A sputum culture is done to:

Detect and identify bacteria or fungi that are causing an infection (such as pneumonia or tuberculosis) of the lungs or the airways leading to the lungs.

Symptoms of a lung infection may include difficulty breathing, pain when breathing, or a cough that produces bloody or greenish brown sputum.

Identify the best antibiotic to treat the infection (sensitivity testing).

Monitor treatment of an infection.

SPUTUM CULTURE

Before doing the procedure, there are keys to remember:

Do not use mouthwash before collecting a sputum sample because it may contain antibacterial substances that could affect your results.

If bronchoscopy will be used to collect your sputum sample, your doctor will tell you how soon before the test to stop eating and drinking. In most cases, you will need to stop eating at least 6 hours before your test. You may be able to drink clear liquids, such as water, coffee, or tea, up to 2 hours before the test. But be sure to follow the exact instructions your doctor gives you.

Tell your health professional if you have recently taken any antibiotics.

SPUTUM CULTURE

Usually, the sputum sample is collected early in the morning before you eat or drink anything. In some cases (especially if you may have tuberculosis), three or more morning samples may be needed.

If you wear dentures, you will need to remove them before collecting a sputum sample. Then rinse your mouth with water, take a deep breath, and then cough deeply to produce a sample of sputum. The health professional collecting the sample may tap on your chest to help loosen the sputum in your lungs before you cough.

If you still have trouble coughing up a sample, you may be asked to inhale an aerosol mist to help you cough.

SPUTUM CULTURE

Sputum collection is performed in different ways:

Bronchoscopy - a thin, lighted tube (bronchoscope) is inserted through your mouth or nose into the airways leading to your lungs. You will be given medication that numbs your throat and nose so you do not feel discomfort from the bronchoscope. You may also be given a sedative to make you sleepy during the procedure. To collect the sputum sample, a salt solution may be washed into the airway and then suctioned into a container. A small, thin brush may be used to collect a sample.

Suctioning - a soft, flexible tube (called a nasotracheal catheter) is inserted through the nose and down the throat. Suction is applied for up to 15 seconds to collect the sputum sample. This method of collecting a sputum sample is often used for people who are very sick or unconscious.

SPUTUM CULTURE Transtracheal aspiration – (This is done in rare cases) A

sputum sample may need to be collected by inserting a needle through the neck into the windpipe (trachea). This is called a. Before a transtracheal aspiration, a local anesthetic is injected into the site where the needle will be inserted. Oxygen may be used before and after a transtracheal aspiration to aid breathing. This method of collecting a sputum sample may be used for people who are very sick and in the hospital.

Once the sputum sample is collected, it will be placed in a container with substances (growth medium or culture medium) that promote the growth of infecting organisms (bacteria or fungi).

Bacteria usually need 2 to 3 days to grow; fungus often takes a week or longer to grow. The organism that causes tuberculosis may take 6 weeks to grow. Any bacteria or fungi that grow will be identified under a microscope or by chemical tests. Sensitivity testing, to determine the best antibiotic to use against the organism that grows, often takes 1 to 2 additional days.

SPUTUM CULTURE

During the procedure, the client will feel discomfort. If you need to inhale the aerosol mist to produce a sputum

sample, you will often feel a deep, uncontrollable urge to cough. During bronchoscopy, you may feel a strong urge to cough as

the bronchoscope or catheter passes into the back of your throat. You may also feel as if you cannot breathe. Try to relax and breathe slowly while the bronchoscope or catheter is in place. If you are given medication to numb your throat and nose, you may feel as if your tongue and throat are swollen and that you cannot swallow.

In transtracheal aspiration, when you are given the local anesthetic, you will feel sharp stinging or burning that lasts a few seconds. When the needle is inserted into the trachea, you will again feel a sharp pain for a few seconds, similar to having your blood drawn. The health professional may ask you to hold your breath during key moments of the procedure.

SPUTUM CULTURE Risks: - soreness in the throat(bronchoscopy/nasotracheal catheter) - a transtracheal aspiration may damage your voice box (larynx) or cause an infection, excessive bleeding, or air to leak from your windpipe (trachea) into the tissues of your neck

Results: - Normal: Sputum that has passed through the mouth normally contains several types of harmless bacteria, including some types of strep (streptococcus) and staph (staphylococcus). The culture should not show any harmful bacteria or fungi. Normal culture results are negative. - Abnormal: Harmful bacteria or fungi are present. The most common harmful bacteria in a sputum culture are those that can causebronchitis or pneumonia (Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumoniae, and Chlamydophila pneumoniae) or tuberculosis (Mycobacterium tuberculosis). Mycoplasma, a group of organisms similar to bacteria, can also cause a type of pneumonia. If harmful bacteria or fungi grow, the culture is positive.