Observation

Question 1

What do you observe in an objective assessment

Answer 1

General appearance- eyes, hands, mouth, oedema, position
Chest-shape, WOB, chest wall movement, breathing pattern 
Skin colour- pale, ruddy, cyanosis 
Abdomen 
Use of accessory muscles 
Nasal flaring
Lines, drains etc 
Oxygen therapy 
Quality of voice

Question 2

What do you observe in the eyes

Answer 2

Pallor- anaemia, plethora- high hb, jaundice, liver/blood disorders, drooping, oedema, fluid retention

Question 3

What do you observe in the hands

Answer 3

Flapping tremor, fine tremor, wastage, clubbing, nicotine stains, cyanosis, temp hot or cold

Question 4

What causes clubbing

Answer 4

Cardiac, congenital heart disease, bacterial endocarditis

Question 5

What to observe in the mouth

Answer 5

Dry/dehydrated, hydrated, cyanosis, pursed lip breathing, oedema, peripheral pitting

Question 6

What to observe in positioning

Answer 6

In bed, slumped, in a chair, position of ease, fixing

Question 7

What to observe in the chest shape

Answer 7

Scoliosis, kyphosis, kyphoscoliosis, pectus excavatum, pectus carinatum, hyper inflated, barrel

Question 8

What to observe in the chest, SOB, WOB

Answer 8

Work of breathing, shortness of breath, position, pursed lip breathing and accessory muscle use, able to talk in full sentences, needing to pause between sentences

Question 9

What to observe in chest wall movement

Answer 9

Symmetrical increase in anteroposterior transverse and vertical diameters of chest, 2 components: anteroposterior posterior angle/ pump handle, transverse angle/ bucket handle