Steps in Assessing Thorax and Lungs Flashcards
What are examples of why assessing the thorax and lungs would be used?
Pneumonia, cystic fibrosis, emphysema or lung cancer
What is the order of respiratory procedures?
- History
2. Assess oxygen saturation
What is the order of Posterior/ lateral procedures?
- Inspection: assess shape and configuration of chest wall, use of accessory muscles, bulging or retraction, skin color and condition
- Palpation: skin (pain, tenderness, temp, masses), Thoracic expansion, Tactile Fremitus
- Percussion: Percussion over posterior and lateral thorax- note tones (tap on finger)
- Auscultation: breath sounds over posterior and lateral thorax, vocal resonance
What is the order of anterior/ lateral procedure?
- Inspection: Assess for costal angle, skin color and condition, inspect trachea, effort of breathing and audible adventitious sounds, inspect lips and nail beds
- Auscultation: Breath sounds
What do you ask the patient during respiratory history?
“Are you experiencing any difficulty with your breathing?”
What do you tell/ ask your patient when you assess oxygen saturation?
“I am going to put this probe on your finger to check your oxygenation, are you having any problems breathing?”
What do you tell your instructor about the oxygen saturation?
O2 saturation in ______%.
What do you tell/ ask your patient during posterior/ lateral inspection?
“Now I am going to look at your chest and assess your breathing from the back. Could you please sit up for me and cross your arms over your chest?”
What do you tell your instructor about the posterior/ lateral inspection?
Note symmetry of chest wall, if oval in shape, AP transverse diameter if spine midline or not. Note ease of breathing and if using accessory muscles. Note Skin color and lesions present.
What do you tell/ ask your patient during posterior/ lateral palpation?
“I’m going to touch your back now. Tell me if you feel any pain or tenderness.” “I want you to breath in slowly and hold it. Okay breathe.” I want you to repeat “99” everything my hand touches you in different areas.”
What do you tell your instructor about the posterior/ lateral palpation?
Note if skin warm, dry and elastic, any tenderness or superficial lumps of masses. State is chest expansion is symmetrical. Describe if tactile fremitus is symmetrical, diminishing inferiorly.
What do you tell/ ask your patient during posterior/ lateral percussion?
“I am going to tap on your back to elicit certain sounds. Let me know if you feel any discomfort.”
What do you tell your instructor about the posterior/ lateral percussion?
State which sound is predominant over the peripheral lung fields.
What do you tell/ ask your patient during posterior/ lateral auscultation?
“I am going to listen over your back. I would like you to breathe through your mouth a little deeper than normal.”
“Now I need your to repeat “99” every time i move my stethoscope.”
What do you tell your instructor about the posterior/ lateral auscultation?
State which breath sounds predominates over the peripheral lung field. Note any wheezes or crackles if present. Note if vocal transmission was soft, muffled and indistinct.
