Wednesday, May 6, 2020

Advance Pulmonary Function Test

Questions: 1. What is your interpretation?2. Discuss the process you used and decisions made in coming to the interpretation.3. Relate the interpretation to the underlying respiratory physiology that determines the volume and flow of measured spirometry. Answers: 1. The patient has an irreversible moderate obstructive disorder because FEV1 is 40% of the normal value and the FEV1/FVC is Pre-measure FEV1 = 1.1/2.7 X 100 = 41% Post measure FEV1 = 42% FEV1 pre measures 1.1 FVC premeasured 1.7 = 0.65 FEV1/FVC post measures = 1.4/1.8 = 0.63 The spirogram indicates that there was no significant change in pre and post measures of both FEV1 and FVC even after introducing the intervention. According to a report by the Jones Medical Instrument Company (2008), a post change of FEV1 of as low as 5% is indicative of reversibility, but in this case, the FEV1 post change is 4%. There is submaximal exhalation and inspiration before and after the intervention. 2. Spirometry was the method used and my interpretation above is based on the cut-offs for Forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), and FEV1/FVC ratio, which are the basic and essential measurements for the interpretation (National Institute of Health, 2016, par. 11). These measures help to determine how much, and how fast one inhales and exhales air. The FEV1/FVC ratio is a diagnostic parameter for air flow obstruction and the confirmation of obstructive disease whose cut-off is 0.7, meaning that a FEV/FVC ration 1 categories as mild, moderate, and severe as shown in the table below, which has been adapted from Pellegrino et al. (cited in Johnson and Theurer 2014). SEVERITY FEV1 PERCENTAGE OF PREDICTED Mild 70 Moderate 60 to 69 Moderately severe 50 to 59 Severe 35 to 49 Very severe 35 The FEV1 is 64%; thus, qualifying the condition to be a moderate obstructive disorder. In this case, there was no significant improvement in the patients condition even after an intervention. 3. Normally, exhalation increases and reaches a peak within the first second before gradually decreasing as all the air is expelled, but in this case, the situation is different. The spirogram indicates that the exhalation of air is limited such that there is strain in emptying the airways unlike in the normal situation; hence forming a concave shape in both pre and post measures. In both pre and post flow-volume curves, there is a decline in airflow such that the individual cannot attain total exhalation. During the pre-test, a dipping pattern is evident. The reduction of FEV1 is an indication of increased resistance to exhalation such that the lungs contain too much air that is difficult to expel. Obstructive diseases include COPD, asthma, chronic bronchitis, and emphysema. In this case due to irreversibility of the obstructive effects, COPD is the obstructive defect in question (Johnson Theurer, 2014). Reference List Johnson, J. D., Theurer, W. M. (2014). A stepwise approach to the interpretation of pulmonary function tests. American Family Physician, 89(5), 359-366. Jones Medical Instrument Company. (2008). Easy spirometry interpretation guide. Drive, Oak Brook: Jones Medical Instrument Company. National Institute of Health. (2016). Pulmonary function tests. Retrieved from https://medlineplus.gov/ency/article/003853.htm. Pearce, L. (2011). How to interpret spirometry results. Nursing Times, 107(43), 18-20.

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