Respiratory Assessment

Question 1

Respiration

Answer 1

Four functions of respiratory control are respiration control, changing chest size during respiration, inspiration and expiration

Question 2

Mechanics of Respiration

Answer 2

Diaphragm drops, intercostals expand rib cage (negatibe pressure in lungs, air rushes in, chest size expands
Diaphragm moves back up, air is expelled

Question 3

Developmental considerations

Answer 3

Infants and children-vulnerability related to small size and immaturity of pulmonary system
Pregnant women-enlarging uterus elevates diaphragm
Older adults-lungs are more rigid, decrease it vital capacity

Question 4

environmental tobacco smoke

Answer 4

second and third hand smoke risk
exposure to both increases risk of adverse health effect
increased respiratory infection, inner ear infection, aggravation of asthma

Question 5

Subjective data

Answer 5

Cough
Shortness of breath
Chest pain when breathing
History of repiratory infections
Smoking history
Environmental exposure
Self care behaviours
OPQRSTU

Question 6

Additional Health history Questions

Answer 6

Infants- Illness, allergies, chronic respiratory illness, safety, environmental smoke,
Older adults-activity intolerance, level of activity, lung disease, pain

Question 7

History questions for infants

Answer 7

4-6 colds per year
smokers at home
child proof or choking hazards
new foods introduced
Do parents know CPR

Question 8

Inspect

Answer 8

Thoracic cage-shape and configuration, skin colour and breathe, accessory muscles, facial expression, level of consciousness

Question 9

Level of consciousness

Answer 9

alert-answers questions
Voice-responds to commands
Pain-responds to painful stimuli
Unresponsive-no response

Question 10

Function of respiratory system

Answer 10

To exchange gases, inhale oxygen and breath out carbon dioxide
Purpose of oxygen in our body is that cells need oxygen to function, keep brain and tissues working

Question 11

Skin colour and condition

Answer 11

Cyanotic=blue (deoxygenated blood)
Pallor=pale (reduced or absent blood flow)

Question 12

Anteroposterior to transverse diameter

Answer 12

1:2
AP-T

Question 13

Patient positions

Answer 13

supine-lying flat on back
Prone-lying flat on their abdomen
Fowler’s position-upright sitting

Question 14

Normal respiration

Answer 14

Normal-active process, uses energy
Expiration-passive process
Does’t use energy

Question 15

Difficulty breathing

Answer 15

Inspiration-active process and accessory muscle use
Expiration-active process!

Question 16

Tripod position

Answer 16

Easier inspiration and expiration
Decreased work of accessory muscle in inspiration
Engages pectoralis minor muscle in lifting rib cage

Question 17

Palpation

Answer 17

chest wall
symmetrical chest expansion
tactile femitus
superficial lumps or masses
Skin-temperature, moisture turgor
No pain or tenderness
No hypertrophy of the neck muscles
Straight line of spinous process

Question 18

Percussion

Answer 18

Predominant note over lung fields-resonance

Question 19

Hyper-resonance

Answer 19

Lower pitched booming sound when too much air is present

Question 20

Dull resonance

Answer 20

abnormal density in lungs

Question 21

Auscultation

Answer 21

Anterior-breath sounds (adventitious sounds)
Posterior-breath sounds -bronchial, vesicular, bronchial breath sounds, adventitious sounds (crackle, wheeze, atelectatic crackle)

Question 22

Adventitious lung sounds

Answer 22

Discontinuous
Crackles-fine
Crackles-coarse
Atelectatic crackles
Pleural friction rub

Continuous
Wheeze-high pitched
Wheeze-low pitched
Stridor

Question 23

Breath sounds

Answer 23

Bronchial-high pitch, loud volume trachea larynx=harsh
Bronchovesicular- moderate pitch, moderate volume
Vesicular-low pitch, low volume

Question 24

What are adventitious breath sounds

Answer 24

added sounds not normally heard
Superimposed on normal breath sounds

Question 25

Assessing Respirations

Answer 25

Tachypnea >20 breaths/minute
Bradypnea <10 breaths/minute
Apnea Hyperventilation increased rate + depth
Cheynes-Stokes respiration- normal infants + older adults during sleep

Question 26

Developmental Considerations

Answer 26

Infants/Children -assess while, sleeping, count respiration, round thorax, broncho-vesicular
Older adults-kyphosis, fatigue, fatigue during auscultation

person acutely short of breathe

Question 27

Measurement

Answer 27

Pulmonary function statues-pulse oximeter (values counted in context of patient’s hemoglobin level, acid based balance and ventilatory status
95-99% is normal
88% with COPD