There are several methods that your doctor may use to make a diagnosis of COPD. An accurate diagnosis must be made in order to obtain important medical information necessary to treat COPD. During the process of trying to make a diagnosis of COPD, your doctor may perform any or all of the following procedures:
History and Physical
During your initial visit, your doctor will obtain a complete history from you. This will include information about your family, previous environmental and occupation exposure, and smoking history. How much you smoke and for how long are important factors that your doctor should know about. So it is important to be completely honest in your disclosure.
A thorough physical examination will be performed that may include:
- Taking your temperature, pulse, breaths per minute, pulse and blood pressure
- Listening to your heart and lungs with a stethoscope
- Examining your ears, nose, eyes and throat for signs of infection
- Examining your fingers for signs of cyanosis and clubbing
- Assessing for signs of swelling in your legs, ankles and feet or other parts of your body
- Evaluating the veins in your neck to assess for complications of COPD such as cor pulmonale
A complete blood count (CBC) will alert your doctor to an infection as well as telling him, among other things, how much hemoglobin is present in your blood. Hemoglobin is the iron-containing pigment in your blood that carries the oxygen from your lungs to the rest of your body.
In COPD, the amount of air that you breathe into and out of your lungs is impaired. Arterial blood gases (ABGs) measure the oxygen and carbon dioxide levels in your blood and determine your body's pH and sodium bicarbonate levels. ABGs are important in forming a diagnosis of COPD as well as in adjusting oxygen therapy.
Your doctor will perform an initial chest X-ray when trying to reach a diagnosis of COPD, and then throughout your treatment to monitor your progress.
Computerized Tomography (CT) Scan
Although a CT is not required for making a diagnosis of COPD, your doctor may order it when it’s indicated (infection is not resolving, change of symptoms, consideration for surgery etc.) While a chest X-ray shows larger areas of density in the lungs, a CT scan is more definitive, showing fine details that a chest X-ray does not. Sometimes, prior to a CT scan, material called contrast is injected into the vein. This allows your doctor to see the abnormalities in your lungs more clearly.
Pulmonary Functions Tests (PFTs)
PFTs are used to evaluate lung function and determine the extent of the damage within your lungs. The most common PFT is spirometry. Read more about PFT's and find out why it is important to know your numbers when it comes to your test results.
A noninvasive method, pulse oximetry measures how well your tissues are being supplied with oxygen. A probe or sensor is normally attached to the finger, forehead, earlobe or bridge of the nose. Pulse oximetry can be continuous or intermittent. A measurement of 95% to 100% is considered normal.
Sputum or mucus from your lungs can be obtained by coughing it up or suctioning. Your sputum specimen will be evaluated in a laboratory and will provide your doctor with a guide in both the diagnosis and treatment of your lung disease.
Measuring the diffusing capacity of the lungs for carbon monoxide (DLCO), tells the doctor how well the air that you breathe travels from your lungs to your blood. Abnormal results mean that your lungs do not have the ability to move gases in and out of the lungs properly. Other pulmonary function tests may also be done as an adjunct to DLCO.
Obtaining a diagnosis of COPD will help your doctor supply you with proper treatment that focuses on slowing the progression of the disease. If you are a smoker, quitting smoking can help lend a hand in this process. Early diagnosis and treatment are extremely important in determining the outcome of COPD.
Source:
Smeltzer, Suzanne C. & Bare, Brenda, G. (1996). Brunnuer and Suddarth's Testbook of Medical-Surgical Nursing (8th Edition). Pennsylvania, PA: Lipponcott-Raven Publishers.
