호흡기계 진단검사

문서 내 토픽

1. X-ray

X-선 검사는 폐결핵 등 폐의 이상을 발견해내는 방법으로 집단 검진시에 사용되거나 병원에 입원하는 사람에게는 정규적으로 시행되는 검사이다. 또한 그 밖의 심장질환이나 종격동의 이상, 종양 등의 이상을 발견해낼 수 있다. 검사 전 간호로는 대상자에게 절차를 설명하고, 옷이나 금속제품은 허리 아래로 내리게 하여 금속의 음영이 찍히지 않도록 하며, 자세를 취해준 후 숨을 깊게 들이마시게 한 다음 사진을 찍을 동안 잠시 숨을 참도록 한다.
2. PFT

폐기능 검사(Pulmonary function test)는 폐기능 장애를 발견하여 분류하고, 손상 정도를 평가하고, 폐질환의 경로를 찾고, 치료의 반응을 평가하고, 흉부수술 대상자의 간호를 계획하는데 필요한 정보를 제공한다. 검사 전 간호로는 대상자에게 검사의 가치와 검사방법, 검사중 발생되는 여러 가지 사실에 대해 자세히 설명해 주어 대상자의 불안을 줄여줄 수 있다. 검사 후 간호로는 검사에서 얻어진 결과를 대상자의 예측치와 비교하여 해석한다.
3. ABGA

동맥혈 가스분석(arterial blood gas analysis : ABGA)은 폐의 가스교환 능력을 알아보는 가장 주된 방법이며, 중환자를 평가하고 관리하는 데 가장 기본적으로 이용하는 검사이다. 동맥혈 가스분석은 PaCO2, PaO2를 측정하여 인공호흡기로 호흡하는 대상자와 COPD 등 폐질환을 갖고 있는 대상자의 호흡기능을 평가한다. 검사 전 간호로는 체혈한 혈액이 응고되지 않게 하고, 채혈 후 바늘 끝에 고무마개를 하여 공기를 차단시킨다. 검사 후 간호로는 천자 부위에 드레싱을 하고 압박하여 출혈을 방지한다.
4. 맥박산소측정기

맥박산소계측은 산소포화(SaO2) 상태를 평가하는 간편하면서도 안전한 방법이다. 이 방법은 비침습적이면서 계속적으로 산화상태를 알 수 있는 것이 장점이다. 검사 전 간호로는 모니터가 필요함을 설명하고, 감지기가 움직이면 잘못 판독될 수 있으므로 대상자에게 감지기를 움직이지 않도록 한다.
5. MRI

MRI는 방사선이 아닌 자기장(magnetic fields)을 이용하여 정밀한 영상으로 보여주기 때문에 CT 스캔보다 더 명확하다. 특히 폐첨부나 척추부근의 영상을 평가하고 비혈관성 구조로부터 혈관을 구별하는데 아주 유용하다. 검사 전 간호로는 대상자에게 검사하는 동안 약 60～90분 정도 누워 있어야 한다고 교육하고, 모든 장신구와 금속은 제거한다.
6. CT

CT(흉부 컴퓨터단층촬영검사)는 폐질환을 진단하기 위해 폐를 층층이 단절하여 촬영한다. 이것은 다른 촬영법에서는 가려져서 영상이 희미했던 병변을 더 자세히 보여준다. 검사 전 간호로는 조영제를 사용할 경우 금식이 필요하고, 검사에 대한 설명과 조영제 사용 동의서를 작성해야 한다.
7. Bronchography

기관지조영술은 기관에 튜브를 삽입하고, 그 관을 통해 물에 녹는 염료나 방사선 불투명액체를 넣어 기관지의 모양, 크기, 유통상태를 알아보는 촬영술이다. 검사 전 간호로는 대상자의 구강간호, 금식, 체위배액 등을 시행하고, 검사 절차와 방법을 정확하게 알려준다. 검사 후 간호로는 들어간 조영제를 제거하고, 합병증 발생 여부를 관찰한다.
8. Pulmonry angiography

폐혈관조영술은 조영제를 혈관에 주입한 후 혈관촬영을 하여 폐의 장애를 평가한다. 이것은 폐색전증, 폐종양, 동맥류, 폐기종에 다른 혈관변화, 선천적인 기형, 수포 등을 진단하는데 유용하다. 검사 전 간호로는 조영제 주입 시 일시적인 몸의 열감을 설명한다.
9. Bronchoscopy

기관지경검사는 기관과 기관지를 관찰하는 것으로, 최근에는 유연하고 나긋나긋한 긴 fiber light bundle을 사용하여 기도를 더 정확하게 볼 수 있게 되었다. 검사 전 간호로는 몰핀이나 meperidine을 투여하고, 대상자를 반듯이 누운 자세에서 목을 뒤로 젖혀 기관지경이 잘 들어가도록 한다. 검사 후 간호로는 의식이 명료하지 못할 때 측위로 누이고, 연하곤란이 있는 경우 침을 뱉어내게 한다.
10. 객담검사

객담 배양검사를 통해 염증의 원인균과 그에 대한 항생제 감수성을 확인한다. 검사 전 간호로는 대상자에게 객담 채취 방법을 설명하고, 방부제 사용을 피하도록 한다. 검사 후 간호로는 객담통을 밀봉하여 냄새와 오염을 방지하고, 즉시 검사실로 보내지 못한 경우 냉장 보관한다.
11. Thoracentesis

흉강천자는 흉막강으로부터 삼출액이나 공기를 제거하는 것으로, 치료와 진단의 목적으로 시행한다. 검사 전 간호로는 필요한 물품을 준비하고, 흉막강내로 대기의 공기가 들어가지 않도록 주의한다. 검사 후 간호로는 천자부위에 압박드레싱을 하고, 대상자를 측와위로 눕혀 천자부위로 삼출물이 새어 나오지 않도록 한다.
12. Lung biopsy

폐생검은 보통 종양을 진단할 때 시행한다. 검사 전 간호로는 피부와 흉막을 국소마취하고, 피부를 약간 절개하여 생검침을 삽입한다. 검사 후 간호로는 기흉, 늑골사이 신경 외상, 혈흉 등의 합병증 발생 여부를 세밀하게 관찰한다.

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1. X-ray

X-ray is a fundamental diagnostic tool in healthcare that provides valuable information about the internal structures of the body. It is a non-invasive and relatively inexpensive imaging technique that can be used to detect a wide range of medical conditions, from fractures and lung diseases to heart and abdominal issues. X-rays work by passing high-energy electromagnetic radiation through the body, which is then captured on a film or digital sensor, creating an image that can be analyzed by healthcare professionals. While X-rays have some limitations, such as the potential for radiation exposure and the inability to visualize soft tissues in detail, they remain an essential component of modern medical practice, providing critical information that helps guide diagnosis and treatment decisions.
2. PFT

Pulmonary Function Tests (PFTs) are a valuable diagnostic tool for evaluating the health and function of the respiratory system. These tests measure various parameters, such as lung volume, airflow, and gas exchange, to provide a comprehensive assessment of a patient's respiratory capabilities. PFTs are particularly useful in the diagnosis and management of conditions like asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung diseases. By quantifying lung function, PFTs can help healthcare providers identify the underlying cause of respiratory symptoms, monitor disease progression, and guide treatment decisions. While PFTs may require some patient cooperation and can be influenced by factors like age and body composition, they remain an essential component of respiratory care, providing objective data that complements clinical observations and helps ensure the delivery of appropriate and effective treatment.
3. ABGA

Arterial Blood Gas Analysis (ABGA) is a critical diagnostic tool in healthcare, providing valuable information about the balance of oxygen and carbon dioxide in a patient's bloodstream. This test involves drawing a small sample of blood from an artery, typically in the wrist or groin, and analyzing it to measure the levels of various gases, including oxygen, carbon dioxide, and pH. ABGA is particularly important in the management of respiratory and cardiovascular conditions, as it can help identify underlying issues such as hypoxemia, acidosis, or respiratory distress. By providing objective data on a patient's gas exchange and acid-base status, ABGA can guide treatment decisions, such as the need for supplemental oxygen, mechanical ventilation, or adjustments to medication regimens. While ABGA can be slightly more invasive than other diagnostic tests, its ability to provide real-time, precise information about a patient's physiological status makes it an essential tool in critical care and emergency medicine settings.
4. MRI

Magnetic Resonance Imaging (MRI) is a powerful diagnostic tool that uses strong magnetic fields and radio waves to create detailed images of the body's internal structures. Unlike X-rays, which rely on ionizing radiation, MRI is a non-invasive and non-ionizing imaging technique that can provide exceptional detail and contrast, particularly in soft tissues like the brain, spinal cord, and musculoskeletal system. MRI is particularly useful in the diagnosis and monitoring of a wide range of medical conditions, from neurological disorders and joint injuries to cancer and cardiovascular disease. By generating high-resolution, three-dimensional images, MRI can help healthcare providers identify subtle abnormalities, track disease progression, and guide treatment decisions. While MRI can be more time-consuming and expensive than some other imaging modalities, its ability to provide detailed, non-invasive information about the body's internal structures makes it an invaluable tool in modern healthcare.
5. CT

Computed Tomography (CT) is a powerful diagnostic imaging technique that uses X-rays and computer processing to create detailed, three-dimensional images of the body's internal structures. CT scans are particularly useful in the evaluation of a wide range of medical conditions, from traumatic injuries and cancer to cardiovascular and neurological disorders. Unlike traditional X-rays, which provide a two-dimensional view, CT scans can generate high-resolution, cross-sectional images that allow healthcare providers to visualize the body's organs, bones, and soft tissues in great detail. This detailed information can help guide diagnosis, treatment planning, and monitoring of disease progression. While CT scans do involve the use of ionizing radiation, which carries a small risk of radiation exposure, the benefits of this imaging modality often outweigh the potential risks, especially in cases where it is necessary for accurate diagnosis and effective treatment. Overall, CT remains an essential tool in modern healthcare, providing critical information that supports timely and appropriate clinical decision-making.
6. Bronchography

Bronchography is a specialized diagnostic imaging technique that uses contrast dye to visualize the airways and lung structures. This procedure involves the instillation of a contrast agent into the bronchial tree, which then allows healthcare providers to use X-rays or CT scans to obtain detailed images of the airways. Bronchography can be particularly useful in the evaluation of conditions affecting the bronchi, such as bronchiectasis, obstructions, or tumors. By providing a detailed view of the airway anatomy, bronchography can help healthcare providers identify the underlying cause of respiratory symptoms, guide treatment decisions, and monitor the progression of certain lung diseases. While bronchography is generally considered a safe procedure, it does carry some risks, such as the potential for allergic reactions to the contrast agent or the development of respiratory complications. As with any diagnostic test, the benefits of bronchography must be carefully weighed against the potential risks, and it is typically reserved for cases where the information it provides is essential for effective patient care.
7. Bronchoscopy

Bronchoscopy is a diagnostic and therapeutic procedure that involves the insertion of a flexible, lighted tube (bronchoscope) into the airways to visualize the respiratory system. This technique is widely used in the evaluation and management of a variety of lung and airway conditions, such as lung cancer, chronic obstructive pulmonary disease (COPD), and respiratory infections. During a bronchoscopy, healthcare providers can obtain samples of lung tissue or fluid for further analysis, as well as perform interventions like removing foreign objects, clearing mucus plugs, or administering targeted treatments. Bronchoscopy is generally considered a safe procedure, but it does carry some risks, such as bleeding, infection, or respiratory distress. The benefits of bronchoscopy, however, often outweigh the potential risks, as it provides valuable information that can guide diagnosis, treatment, and ongoing management of respiratory conditions. As with any medical procedure, the decision to perform a bronchoscopy should be made carefully, taking into account the individual patient's needs and the expertise of the healthcare team.
8. Thoracentesis

Thoracentesis is a medical procedure in which a small amount of fluid is removed from the space between the lung and the chest wall (the pleural space) using a needle. This procedure is typically performed to diagnose or manage conditions that can cause the accumulation of fluid in the pleural space, such as pleural effusions, empyema, or malignant pleural effusions. By analyzing the fluid sample obtained during thoracentesis, healthcare providers can determine the underlying cause of the fluid buildup and guide appropriate treatment. Thoracentesis is generally considered a safe procedure, but it does carry some risks, such as the potential for bleeding, infection, or lung collapse. The benefits of thoracentesis, however, often outweigh the potential risks, as it can provide critical information that supports timely and effective management of respiratory conditions. As with any medical procedure, thoracentesis should be performed by a trained healthcare professional, and the decision to perform the procedure should be made carefully, taking into account the individual patient's needs and the potential risks and benefits.
9. Lung biopsy

A lung biopsy is a medical procedure in which a small sample of lung tissue is removed for analysis. This procedure is typically performed to diagnose various lung conditions, such as lung cancer, interstitial lung diseases, or infections. Lung biopsies can be performed using different techniques, including needle biopsy, open surgical biopsy, or video-assisted thoracoscopic surgery (VATS). The choice of biopsy method depends on the location and size of the lesion, as well as the patient's overall health and medical history. While lung biopsies are generally considered safe, they do carry some risks, such as bleeding, pneumothorax (collapsed lung), or infection. The benefits of a lung biopsy, however, often outweigh the potential risks, as it can provide critical information that supports accurate diagnosis and guides appropriate treatment. As with any medical procedure, a lung biopsy should be performed by a trained healthcare professional, and the decision to perform the procedure should be made carefully, taking into account the individual patient's needs and the potential risks and benefits.

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