NURS 612 Key Points to Review for Exam 2.Key Point to
Review – Chest
/ Lungs
STUDENT NOTES
What are
examples of
appropriate
history of
... [Show More] present
illness questions
you may ask a
patient with a
chief complaint
of a respiratory
issue?
Do you have a cough?
Is your cough sudden, gradual?
What is the duration of your cough?
Please describe your cough. Is it dry, moist, wet, hacking, hoarse, barking,
whooping, bubbling, productive, nonproductive?
Do you have sputum when you cough? What does the sputum look like? Clear,
purulent, blood-tinged, mostly blood, foul odor?
How often do you cough? Occasional, regular, paroxysmal?
Are you your cough related to time of day, weather, activities like exercise,
talking, deep breaths, or change over time?
Does your cough disrupt your sleep or conversation? Does it cause chest pain?
Do you have any associated symptoms? Like shortness of breath, chest pain
or tightness with breathing, fever, nasal congestion, noisy respirations,
hoarseness, gagging?
Have you been taking in medication to treat your symptoms, over the counter
medication, prescribed medication, or vaporizers?
Describe how you
would inspect the
chest. How do
you describe the
size shape (A/P
diameter) and
symmetry of the
chest? What are
the thoracic
landmarks?
Inspect the chest from the front and back.
1. Assess its size and shape. The anteroposterior diameter (AP) is ordinarily
less than the transverse diameter. AP diameter is expressed in thoracic
ratio. The AP diameter is shorter than the lateral diameter, ex: 1:2
2. Check for symmetry. You can use one side to compare with the other.
3. Consider the thoracic landmarks and observe the costal angle, angle of
the ribs and intercostal spaces.
4. Note the color of the skin, noting any cyanosis or pallor.
5. Check for supernumerary nipples.
6. Look for superficial venous patterns, which may signal a cardiovascular
disease.
7. Observe the prominence of the ribs as a clue to general nutrition.
Thoracic landmarks: anterior thorax, right lateral thorax, posterior thorax
Describe how you
assess the rate
and quality of
respirations?
What is normal
and abnormal?
Assess respirations for two characteristics
1. Count the respiratory rate, which should be 12 – 20 breaths/min.
2. Note the pattern (or rhythm) or respirations. The patient should
breathe easily and regularly and without distress. Chest expansion
should be bilaterally symmetrical.
Abnormal respirations
Tachypnea – persistent respiratory rate approaching 25 breaths/min
Bradypnea – rate slower than 12 breaths/min
Hyperpnea – deep breathing
Kussmaul breathing – deep, usually rapid breathing associated with
metabolic acidosis
Hypopnea – abnormally shallow respirations
Cheyne-Stokes respiration – regular breathing with intervals of apnea [Show Less]