Week 1 - Objective Assessment

Question 1

What techniques are involved with an objective assessment?

Answer 1

Observation
Palpation
Auscultation
CXRs/ imaging
PFTs
Pulse Oximetry
Arterial Blood Gases
Function ability/ QOL
Exercise tolerance/ tests
Charts (+/ critical care)

Question 2

What are you looking for during observation?

Answer 2

General appearance
Position
Chest - shape, WOB, chest wall movement, breathing pattern
Skin colour
Abdomen
Use of accessory muscles
Nasal flaring
Lines, drains
O2 therapy
Quality of voice

Question 3

What might you observe by looking at the eyes?

Answer 3

Pallor (anemia)
Plethora (high Hb)
Jaundice - liver/ blood disorder
Drooping (could be sign of lung cancer)
Oedema

Question 4

What might you observe by looking at the hands?

Answer 4

Flapping tremor (too much CO2)
Fine tremor (could be related to drugs)
Wastage (e.g. thenar wastage could be lung cancer)
Clubbing
Nicotine stains
Cyanosis (peripheral/ central)
Temp - hot/ cold

Question 5

What are the possible causes of clubbing?

Answer 5

Usually as a result of a long term problem
Cardiac - congenital heart disease, bacterial endocarditis
Lung - infective, fibrotic

Question 6

What might you observe by looking at the mouth?

Answer 6

Dry/ dehydrated
Cyanosis
Purse lip breathing

Question 7

What might you see by looking at position?

Answer 7

Have they chosen a position of ease

Fixing - shows involvement of accessory muscles

Question 8

What are four chest shapes you may see?

Answer 8

Scoliosis
Kyphosis
Pectus Excavatum
Hyperinflated

Question 9

What are you looking for when observing chest wall movement?

Answer 9

Symmetrical increase in A-P; transverse and vertical diameters of the chest
Pump handle and bucket handle movement