Nursing /Simmons NURP 502 Exam 1 COPD Diagnosis
Simmons NURP 502 Exam 1 COPD Diagnosis
This deck covers key concepts and diagnostic criteria for COPD as outlined in the Simmons NURP 502 course. It includes questions on spirometry measurements, diagnostic imaging, differential diagnoses, and assessment tests.
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? FEV1
Decreased
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Key Terms
Term
Definition
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? FEV1
Decreased
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? FEV1/FVC Ratio
Decreased
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? Total Lung Capacity (TLC)
Normal or Increased
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? Residual Volume (RV)
Increased
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? Diffusing Capacity (DLCO)
Normal or Decreased
In a COPD diagnosis, what would postbronchodialtor FEV1 be?
≤ 80% predicted
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| Term | Definition |
|---|---|
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? FEV1 | Decreased |
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? FEV1/FVC Ratio | Decreased |
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? Total Lung Capacity (TLC) | Normal or Increased |
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? Residual Volume (RV) | Increased |
In a COPD diagnosis, would you expect the measurement to be increased, decreased, or normal? Diffusing Capacity (DLCO) | Normal or Decreased |
In a COPD diagnosis, what would postbronchodialtor FEV1 be? | ≤ 80% predicted |
In a COPD diagnosis, what would postbronchodialtor FEV1/FVC ratio be? | < 0.70 |
What diagnostic is standard for initial diagnosis of COPD? | CXR to see lung hyperinflation |
On a CXR, what indicates COPD? | • Visible bullae, decreased parenchymal markings, or hyperlucency (emphysema) • Increased lung volumes, flattening of diaphragm • Enlarged heart |
T/F CXR is all that is needed for COPD diagnosis. | False. Not stand-alone diagnostic, but can r/o other alternatives. |
CXR is seldom diagnostic for COPD without obvious _____. | CXR is seldom diagnostic for COPD without obvious bullous disease. |
Though not a 1st-line test, what can be used to r/o malignancy when diagnosing COPD? | CT |
Who qualifies for alpha-1 antitrypsin (AAT) deficiency testing? | • <45 yo • Caucasian descent • Strong family hx of COPD |
What AAT value strongly suggests deficiency? | 15-20% below normal |
What labs would you order in COPD diagnosis? | •Serum chemistry • Sodium retention. • K+ levels lowered by diuretics, B agonsts, and theophylline. • Renal excretion of Ca and Mg increased by B adrenergic agonists. May be important with hypokalemia. • CBC • Hematocrit imbalance (usually mild polycythemia). • BNP • May not give straightforward differentiation from CHF. |
When is an ABG ordered? | For stable persons with FEV1 less than 50% or with right-sided heart failure (inpatient) |
Which differential dx is this? • Early-life onset • Positive family hx • Allergies • Reversible obstruction | Asthma |
Which differential dx is this? • Older adults • Basilar crackles • Cardiomegaly • Pulmonary edema on CXR | CHF |
Which differential dx is this? • Excessive purulent sputum • Bacterial pathogen • Bronchial dilation and thickening on CXR | Bronchiectasis |
Which differential dx is this? • All ages • Infiltrate, nodular lesions or granuloma on CXR • High local prevalence | Pulmonary TB |
In making a COPD diagnosis, what is looked for on PE? | 1. Breathlessness test (e.g., 6-minute walk) 2. Body mass index (BMI) 3. Chest inspection and auscultation 4. Vital signs including pulse oximetry |
In making a COPD diagnosis, what is looked for on spirometry? | 1. Baseline test 2. Postbronchodilator FEV1 (value less than 70% of predicted indicates COPD) |
What are 2 questionnaires administered for COPD? | 1. COPD Population Screener (COPD-PS) 2. Lung Function Questionnaire (LFQ) |
How is the 6-minute walk test administered? | • 30 m marked every 3 meters including turnaround points • Record time/lap before patient must stop for breath • Monitor pulse oximetry |