Thorax and Lung Assessment

Summary

Nurse Nancy introduces herself to Mr. Hoffman and explains that she will be assessing his respiratory system. She begins with a health history inquiry, noting he has no smoking history or lung problems. Nancy proceeds with a physical examination, observing normal respiratory rate and rhythm, symmetric chest shape, and absence of retractions. She palpates the chest for tenderness or abnormalities and checks for skin color changes. Nancy then auscultates lung sounds, moving from the trachea to the chest's anterior, lateral, and posterior areas, listening for normal vesicular breath sounds. The assessment concludes with normal findings.

Takeaways

• 😷 The nurse, Nancy, is conducting a respiratory system assessment for Mr. Hoffman.
• 🚬 Mr. Hoffman has no current or past history of smoking cigarettes or any other form of tobacco.
• 🏥 The patient denies any history of lung problems such as asthma, emphysema, or bronchitis.
• 🔍 The nurse begins with an inspection, noting Mr. Hoffman's respiratory rate and rhythm are within normal limits.
• 👀 The nurse observes no retractions or bulging of the interspaces, and the patient's posture is upright.
• 🔢 The anterior-posterior to transverse ratio of the chest is noted to be within the normal range of 2:1.
• 👐 During palpation, the nurse checks for tenderness, pain, and any abnormal bumps, bruises, or masses.
• 🌡 The nurse also inspects the skin for any signs of pallor, pick Hale, or cyanosis while palpating.
• 💪 The patient is asked to stand and perform a deep breath to assess chest expansion symmetry.
• 👂 Auscultation is performed to listen to lung sounds, starting at the trachea and moving across different lung areas.
• 🗣️ The patient is instructed to breathe deeply and through the mouth to facilitate clear lung sound auscultation.
• 🔊 Breath sounds heard over the trachea, sternum, and back are described as vesicular, indicating normal lung function.

Q & A

What is the purpose of the assessment being conducted by Nancy?

The purpose of the assessment is to evaluate Mr. Hoffman's respiratory system.

What are the two initial questions Nancy asks Mr. Hoffman?

Nancy asks if Mr. Hoffman currently smokes cigarettes and if he has ever smoked in the past.

What respiratory conditions is Nancy inquiring about in Mr. Hoffman's medical history?

Nancy inquires about any history of lung problems such as asthma, emphysema, and bronchitis.

What observations does Nancy make during the inspection phase of the assessment?

Nancy notes that Mr. Hoffman's respiratory rate is within normal limits, the rhythm is regular, respirations are deep, there are no retractions or bulging of the interspaces, and the chest is symmetric with a normal anterior-posterior to transverse ratio.

What does Nancy look for when she palpates Mr. Hoffman's chest?

Nancy palpates the chest to check for tenderness, pain, abnormal bumps, bruises, masses, and to observe the skin for any abnormalities such as pallor, pick Hale, or cyanosis.

How does Nancy assess the expansion of Mr. Hoffman's chest?

Nancy assesses chest expansion by placing her thumbs on the chest and asking Mr. Hoffman to take a deep breath in and out, observing the symmetrical movement of her hands.

What is the significance of auscultation in the respiratory assessment?

Auscultation is significant as it allows Nancy to listen to the lung sounds and identify any abnormal breath sounds that may indicate a respiratory issue.

What areas does Nancy auscultate during the assessment?

Nancy auscultates the trachea, the area near the sternum, the periphery of the chest, and the posterior area, comparing side to side as she goes down the chest.

What type of breath sounds does Nancy expect to hear over the trachea and the periphery of the lungs?

Nancy expects to hear bronchovesicular breath sounds over the trachea and vesicular breath sounds in the periphery of the lungs.

What does the absence of abnormal breath sounds during auscultation suggest about Mr. Hoffman's respiratory health?

The absence of abnormal breath sounds suggests that Mr. Hoffman's respiratory system is functioning normally, with no apparent respiratory issues detected during the assessment.

How does Nancy ensure that the auscultation process is thorough and accurate?

Nancy ensures thoroughness and accuracy by listening to a full breath in each spot, comparing side to side, and following a systematic pattern across the anterior, lateral, and posterior areas of the chest.