N 295 lecture 7 respiratory student copy
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This document provides an overview of assessing the thorax and lungs. It discusses inspecting the chest shape and symmetry, respiratory patterns, auscultation of breath sounds in different areas, palpation techniques, and common abnormalities that may be found. Developmental and cultural considerations are also mentioned. The goal is to perform a thorough respiratory assessment and identify any respiratory issues.
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Editor's Notes
- Suggested Interview Questions : Environmental Exposure : Have you been exposed to environmental or occupational materials that have affected your breathing? What are they? S/S of resp. dysfunction : Have you had allergies, asthma, bronchitis, emphysema, bronchitis, TB or other lung problems? How often do you cough? Describe sputum? Impact on ADLS: Do any of your breathing problems limit your activities? Adaptive Measusee: What position do you assume for sleeping? When Interviewing keep in mind these important respiratory symptoms: COUGH: Do you have a cough?If so, How long? Suddenly or gradually? does it waken you at night?what does it sound like/ describe it? Acute illness=cough throughout the day environmental exposure=occurs at time in relation to exposure post nasal drip/ sinusitis=at night sound= dry, mois,t wet, hacking, hoarse,productive, nonproductive pneumonia, -hacking, congested cough, croup- barking,HF dry cough SPUTUM: Nl sputum is thin, clear white in color, tasteless odorless, rust colored=pneumonia, yellow-green-bacterial infection DYSPNEA/SOB; Does SOB occurs @ restorw/activity? problems breathing @ night? PND=paraoxysmal nocturnal dyspnea, orthopnea=SOB while lying flat, Ask about the # of pillows. HEMOPTYSIS: produces alarm in pt, Coughing up clots--> serious illness CA, tumor PE. Blood tinged= associated w/ smoking, minor infectionsn and serious diseas. H/o TB, bronchitis recent travel? (prolonged sitting--> DVT--->PE, medication HX (anticoagulants, birth control pills). At times it may be difficult to ascertain if patient coughed up or vomited blood. Chest pain (pleuritic Pain): inflammed parietal pleura, nerves are abundant in this area. Sharp, stabbing pain usually during inspiration. may be localized (client splinting to avoid pain) WHEEZING: asthma is associated w/ wheezing but not all wheezing is asthma. CYANOSIS: central cyanosis occurs w/ inadequate gas exchange. bluish discoloration bets seen in the mucous membrane of the mouth & lips. clubbing of the nail bed is associated w/ this