An older client is scheduled for diagnostic testing. What is the best indication for the client to undergo pulmonary function tests?
1. Chest x-ray demonstrating bilateral infiltrates
2. Abnormal arterial blood gas analysis results
3. The presence of hemoptysis and fatigue
4. Chronic wheezing with an undiagnosed cause
4. Chronic wheezing with an undiagnosed cause
Explanation: 1. A chest x-ray will give information related to the pulmonary condition. Infiltrates often indicate pneumonia or similar process. If this information is not specific enough, a CT scan is the next diagnostic test the nurse anticipates.
2. An abnormal ABG is treated with medications or ventilation assistance. Further testing is not warranted until the imbalance is corrected.
3. Hemoptysis and fatigue are indications for a battery of respiratory tests, including CT or PET scan or bronchoscopy. A pulmonary function test may be included, but it is not the best indication for this test.
4. Pulmonary function tests are the most reliable way to diagnose asthma and differentiate it from other illness such as COPD. Measurement of air during expiration is used in the differential diagnosis.
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