C/R objective assessment

Question 1

What do you palpate on assessment?

Answer 1

Abdomen movement
Chest expansion
Equal on both sides?
Sputum crackles
Cold or warm temperature

Question 2

What are some special tests?

Answer 2

Auscultation - listen to lung sounds
Chest X-rays - look at structures
Pulmonary function tests - e.g. Spirometry - measure maximum exertion (80% in 1 sec is norm)
Exercise tolerance - 6-12 minute tests, shuttle walk test
HR and BP
Pulse oximetry - measures arterial oxygen saturation and haemoglobin% (machine on finger)
ECG - electrical activity in the heart

Question 3

What happens when you breathe in?

Answer 3

Diaphragm descends
Upper ribs and sternum move upwards and forwards - pump handle
Lower ribs - up and out - bucket handle movement

Question 4

Explain two breathing exercises

Answer 4

Thoracic expansion exercises -

hold hands around rib cage and get patient to breathe in as much as they can and hold
With sniff = increase air in

Breathing control for diaphragmatic breathing -

hold under ribs and breathe in

Question 5

What are you looking for on observation?

Answer 5

Red - high rbc
Pale - low bp
Cyanosis - low oxygen levels 
Breathing rate 
Breathing pattern 
Thin 
Puckered lips - to keep lungs open so increase air in 
Energy levels
Leaning forwards? 
Chest shape (barrel shaped = hyper inflated)