Respiratory Examination Flashcards

1
Q

Respiratory Examination

Why is it important to introduce yourself and check the patient’s identity before starting the respiratory examination?

A

Establishing rapport and confirming identity ensure patient trust and safety during the procedure.

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2
Q

Respiratory Examination

What should you explain to the patient during the introduction, and why is obtaining informed consent necessary?

A

Explain the procedure and obtain informed consent to respect the patient’s autonomy and ensure they are aware of the examination.

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3
Q

Respiratory Examination

Why is general inspection considered an essential component of all systems examinations, including respiratory?

A

General inspection can provide valuable clues about the patient’s overall condition and may lead to diagnosis without physical contact.

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4
Q

Respiratory Examination

What are the key elements to observe during general inspection from the end of the bed in the respiratory examination?

A

Look for patient alertness, comfort, skin color (cyanosis), signs of breathlessness, posture, and the presence of accessories like oxygen, medications, and walking aids.

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5
Q

Respiratory Examination

Why do we start the peripheral examination with the hands, and what signs are we looking for?

A

Starting with the hands allows for the observation of clubbing, tar staining, peripheral cyanosis, small muscle wasting, tremors, and asterixis.

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6
Q

Respiratory Examination

What is the significance of assessing the heart rate and respiratory rate during the peripheral examination?

A

Assessing heart rate and respiratory rate provides information about the patient’s cardiovascular and respiratory status.

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7
Q

Respiratory Examination

What are the steps involved in the inspection of the anterior and lateral chest during the respiratory examination?

A

Look for scars, chest wall movement, deformities, and other abnormalities. Palpate for expansion, check tactile vocal fremitus, percussion, and auscultate.

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8
Q

Respiratory Examination

Why is it recommended to complete the IPPA for one side of the chest before moving to the other side?

A

Completing IPPA for one side first minimizes patient discomfort, and the posterior chest often provides more information.

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9
Q

Respiratory Examination

Why do we perform a cervical lymph node examination and inspection/palpation of lower limbs to conclude the respiratory examination?

A

To assess for abnormalities such as lymph node enlargement and signs of deep vein thrombosis or pitting edema.

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10
Q

Respiratory Examination

How would you explain the next steps to the patient or summarize findings to the supervisor at the end of the examination?

A

Provide clear information on the next steps, such as reporting findings to the supervisor or the doctor, ensuring patient understanding.

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11
Q

Respiratory Examination

What is the standard order of approach for the central examination, and what components does it involve?

A

The standard order is Inspection, Palpation, Percussion, and Auscultation (IPPA). Components include looking for scars, chest wall movement, deformities, expansion, tactile vocal fremitus, and auscultating for breath sounds.

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12
Q

Respiratory Examination

What aspects are assessed during the Posterior Chest Examination, and what is the order of assessment?

A

Assess scars, kyphosis, expansion (bucket-handle movement), tactile vocal fremitus, and auscultate for breath sounds. The order is Inspection, Palpation, Percussion, and Auscultation (IPPA).

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13
Q

Respiratory Examination

: What steps should be taken to conclude the respiratory examination, and why is it important to thank the patient?

A

Conclude by thanking the patient, ensuring comfort, washing hands, explaining the next steps to the patient, and summarizing findings to the supervisor if applicable.

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14
Q

Respiratory Examination

How would you explain the next steps to the patient or summarize findings to the supervisor at the end of the examination?

A

Provide clear information on the next steps, such as reporting findings to the supervisor or the doctor, ensuring patient understanding.

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15
Q

Respiratory Exam

Identify

Inspection

A

Peripheral Cyanosis

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16
Q

Respiratory Exam

Identify

Inspection

A

Tar Staining

17
Q

Respiratory Exam

Identify

Inspection

A

Clubbing

18
Q

Respiratory Exam

Identify

Inspection

A

Palmar Palor

19
Q

Respiratory Exam

Identify

Inspection

A

Small Muscle wasting

20
Q

Respiratory Exam

Identify

Inspection

A

Conjunctival Palor

21
Q

Respiratory Exam

Identify

Inspection

A

Central Cyanosis

22
Q

Respiratory Exam

Identify

Inspection

A

Prominent Chest Wall veins

23
Q

Respiratory Exam

Identify

Inspection

A

Pitting Oedema

24
Q

Respiratory Exam

Identify

Inspection

A

Horners Syndrome (left eye)

25
Q

Respiratory Exam

Identify

Inspection

A

Small Muscle wasting

26
Q

Respiratory

INTRODUCTION

A

Name/role
Check patients name
Explain examination and exposure
Explain that they will be examined again by supervisor
Consent
Offer Chaperone
Document
Ask about pain
Clean your hands and stethoscope (unless using patients own)
Position at 45 degrees
Ensure adequate exposure

27
Q

Respiratory

BEDSIDE INSPECTION

A

Oxygen
Inhalers/ nebulisers/ medications Sputum pot
Walking aids

28
Q

Respiratory

GENERAL INSPECTION OF PATIENT AND ENVIRONMENT

A

Well/unwell
Pain/discomfort
Breathlessness, accessory muscle use
Coughing
Wheeze

29
Q

Respiratory

HANDS AND NAILS

A

Colour
Cyanosis
pallor
Tar staining
Clubbing
Fine tremor (salbutamol)
Flap (carbon dioxide retention)

30
Q

Respiratory

RESPIRATORY RATE

A

15 x 4

31
Q

Respiratory

HEART RATE

A

Brady Tachy?

32
Q

Respiratory

FACE

A

Horner’s syndrome
Mouth (central cyanosis)
Anaemia

33
Q

Respiratory

NECK

A

Scars
Lumps/visible nodes
Tracheal deviation
JVP

34
Q

Respiratory

CHEST

INSPECTION

A

Shape
Scars
Accessory muscle usage
Prominent chest veins (indicative of SVC obstruction)
Fixing rib cage
Expansion

35
Q

Respiratory

PALPATION

A

Expansion
Tactile vocal fremitus*

36
Q

Respiratory

PERCUSSION

A

Resonance/dullness
Do the anterior and lateral aspects of the chest first (clavicle/ apex, upper anterior chest, lateral chest in nipple line – comparing sides), and then do the posterior aspects with the patient sitting up (upper zone, mid zone, lower zone – comparing sides).

37
Q

Respiratory

AUSCULTATION

A

Lung sounds
Vocal resonance*
*Either vocal fremitus or vocal resonance

38
Q

Respiratory

FINISH WITH

A

CERVICAL LYMPH NODES

ANKLES (FOR PITTING OEDEMA)