Diagnostic Procedures

• Tuberculin Skin Test: Mantoux Test

  • Purified Protein Derivative is used.
  • Intradermal route of injection.
  • Read results 48 to 72 hours after injection.
  • (+) mantoux test = induration of 10 mm or more.
  • HIV patients: (+) mantoux test = induration of 5 mm.
  • (+) mantoux test signifies exposure to mycobacterium tubercle bacilli
  • (+) BCG = false positive Mantoux Test

  * Alternative = Quantiferon TB
• Chest Xray

  • Practice client on how to hold breath and to do deep breathing.
  • Instruct client to remove metals from chest.
• Bronchography

  A radiopaque medium is instilled directly into the trachea and bronchi through bronchoscope and visualized through xray.
• Bronchography


  A radiopaque medium is instilled directly into the trachea and bronchi through bronchoscope and visualized through xray.
• Bronchography: Nursing Interventions - Before

  • Consent
  • Check for allergies to seafood, iodine, or anesthesia.
  • NPO: 6 to 8 hours
  • Remove dentures
• Bronchography: Nursing Interventions - After

  • Position - Side-lying or semi fowlers
  • NPO until cough and gag reflexes return.
• Bronchoscopy


  Direct inspection and observation of the larynx, trachea, and bronchi through flexible rigid bronchoscope.
• Bronchoscopy: Diagnostic Uses

  • To collect secretions
  • To determine location and collect specimen for biopsy
• Bronchoscopy: Therapeutic Uses

  • To remove aspirated foreign objects
  • To excise lesions
• Bronchoscopy: Nursing Interventions - Before & After

  • Same with bronchography
• Lung Scan

  • following injection of radioisotope, scans are taken with scintillation camera.
• Lung Scan confirms pulmonary embolism.
• Lung Scan

  The client should remain still during the procedure.
• Lung Scan confirms pulmonary embolism.
• Sputum Test 


  Specimen obtained by expectoration or tracheal suctioning.
• Sputum Test

  • After antibiotics - to evaluate effectiveness of medications given.
• Sputum Test

  • Before antibiotics - to determine actual microorganisms causing infection.
• Sputum Test

  • For C & S - sputum test before first dose of antimicrobial.
• Sputum Test

  • For AFB - collect sputum specimen for 3 consecutive mornings.
• Sputum Test for TB: Early morning or Afb Staining?

  AFB staining
• Sputum Test

  • Early morning sputum specimen is collected. 15 mL
• Sputum Test

  • Rinse mouth with plain water.
• Pulmonary Function Studies

  • Tests used to measure lung volumes and lung capacities.
• Pulmonary Function Studies

  • Vital Capacity - the maximum volume of air that can be exhaled after a maximum inhalation.
• Pulmonary Function Studies

  • Vital Capacity - reduced in COPD.
• Pulmonary Function Studies

  • Tidal Volume - the volume of air inhaled and exhaled with normal quiet breathing.
• Pulmonary Function Studies

  • Inspiratory Reserve Volume - the maximum volume that can be inhaled following a normal quiet breathing.
• Pulmonary Function Studies

  • Expiratory Reserve Volume - the maximum volume that can be exaled following a normal quiet breathing.
• Pulmonary Function Studies

  • Functional Residual Capacity - the volume of air that remains in the lungs after a normal quiet breathing.
• Pulmonary Function Studies

  • Residual Volume - the volume of air that remains in the lungs after a forceful breathing.
• Pulmonary Function Studies

  • Vital Capacity - the maximum volume of air that can be exhaled after a maximum inhalation.
• Pulmonary Function Studies

  • Tidal Volume - the volume of air inhaled and exhaled with normal quiet breathing.
• Pulmonary Function Studies

  • Inspiratory Reserve Volume - the maximum volume that can be inhaled following a normal quiet breathing.
• Pulmonary Function Studies

  • Expiratory Reserve Volume - the maximum volume that can be exhaled following a normal quiet breathing.
• Pulmonary Function Studies

  • Functional Residual Capacity - the volume of air that remains in the lungs after a normal quiet breathing.
• Pulmonary Function Studies

  • Residual Volume - the volume of air that remains in the lungs after a forceful breathing.
• Arterial Blood Gas

  • to assess ventilation and acid-base balance
• Arterial Blood Gas

  • 10 mL pre-heparinized syringe is used (to prevent clotting of specimen)
• Arterial Blood Gas

  • Radial artery = common site for withdrawal of blood specimen
• Arterial Blood Gas

  • Place the container with ice to prevent hemolysis of the specimen.