Respiratory Assessment

Question 1

What can a tracheal shift indicate?

Answer 1

• The trachea may be pushed to the healthy side with a pneumothorax, aortic aneurysm, tumour or unilateral thyroid lobe enlargement.
• The trachea is pulled towards the affected (diseased) side with significant atelectasis, pleural adhesions or fibrosis.
• Tracheal tug is a rhythmic downwards pull that is
  synchronous with systole and occurs with aortic arch aneurysm

Question 2

What do we look for when assessing colour of patient?

Answer 2

Cyanosis (bluish-purple discolouration) in lips, fingertips, earlobes, face and mucous membranes. Can be a sign of low oxygen in blood.

Question 3

What does the quality of breath mean?

Answer 3

If patient is using accessory muscles, if they have increased/decrease respiratory rate, nasal flare and if they have any signs of increased work of breathing

Question 4

What does uneven chest expansion indicate?

Answer 4

Unequal chest expansion occurs when part
of the lung is obstructed or collapsed, as with pneumonia
or when guarding to avoid postoperative incisional pain
or pleurisy pain.

Question 5

What are the landmarks to look for when doing a respiratory assessment?

Answer 5

• C-7 (most prominent bony spur at lower neck)
• T-10
• Spine
• Scalpula (back shoulder blade)
• Ribs

Question 6

What is barrel chest a sign of?

Answer 6

COPD, emphysema, osteoarthritis, and CF

Question 7

How do you assess for even respiratory excursion?

Answer 7

Place thumbs together at centre of chest and ask patient to breathe in and out.

Question 8

What percussion sounds to make note of?

Answer 8

Resonant - low-pitched, clear, hollow sound that
predominates in healthy lung tissue in the adult.
Hyper resonance -lower-pitched, booming sound
found when too much air is present, as in emphysema or pneumothorax.
Dull - signals abnormal density the lungs, as with pneumonia, pleural effusion,
atelectasis or tumour.
Typanic - high pitched drum like sound, over pneumothorax or asthma.

Question 9

How should you move across the chest when listening for breathing sounds?

Answer 9

Move down from mid clavicular to 2nd, 4th, 6th and 8th intercostal spaces, moving left to right. Both anterior and posterior

Question 10

What is Seretide?

Answer 10

Seretide is a corticosteroid and Beta 2 agonist, it is an inhaler used regularly to treat COPD and asthma.

Question 11

How does seretide work?

Answer 11

Reduces airway inflammation and bronchial hyper-reactivity and relaxes bronchial smooth muscle by stimulating beta2 adrenoreceptors.