NURS612 Key Points to Review for Exam 2
1 | P a g e
Key Point to
Review –
Chest / Lungs
STUDENT NOTES
What are
examples of
appropriate
history
... [Show More] of
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
followed by crescendo-decrescendo breathing
NURS612 Key Points to Review for Exam 2
2 | P a g e
Key Point to
Review –
Chest / Lungs
STUDENT NOTES
➢ Biot respiration – irregular breathing that varies in depth and is
interrupted irregularly by interval [Show Less]