Summary NURS 201 REVIEW FOR QUIZ 3

Summary NURS 201 REVIEW FOR QUIZ 3 Chapter 16 (Respiratory) Review picture from slide 8 • Respiratory cycle: – Eupnea ▪ Regular, even, rhythmic pattern of breathing – Dyspnea ▪ Change in this pattern producing shortness of breath or difficulty breathing Slide 20,21,22,23,25, 26 (on this slide noted T3 spinous process, and 6th rib midaxillary line) (pictures slides), 27 Patient positioned and gowned for assessment- Pt. should be in a siting position. Pt. should only have a gown/drape. Stand in front of the pt. Lightening should be adequate to detect color differences, lesions, & chest movements. Explain procedure & ask the pt. to breath normally. Observe skin color & symmetry of structures. Inspect for chest configuration: The adult transverse diameter is twice that of the anteroposterior diameter (AP: T=1:2) Slide 46 (see picture) Pattern for palpating the posterior thorax- Explain that you will be palpating (touching) the pt.s back to determine if there is any area of tenderness & to inform you if pain or discomfort is felt in any area touched. Pain may occur with fibrous tissue or underlying structures: pleura. Crepitus is a crunching feeling under the skin caused by air leaking into subcutaneous tissue. Palpation for respiratory expansion- movement of the chest during breathing by placing the hands on the lower chest & asking the pt. to take a deep breath. Place the palmar surface of your hand, with the thumbs close to the vertebrae, on the chest at the T10. Pinch up some skin between your thumbs. Ask the pt. to take & deep breath. The movement & pressure of the chest against your hands should feel smooth & even. Your thumbs should move away from the spine & skin should move smoothly as the chest moves with inspiration. Unilateral decrease or delay in expansion may indicate underlying fibrotic or obstructive lung disease or pneumothorax. Palpation for tactile fremitus using metacarpophalangeal joint area- Fremitus is the palpable vibration on the chest wall when the client speaks (stronger over the trachea & diminishes over the bronchi & almost non-existent over the alveoli. Use one palmar surface of the hand at the base of the fingers surface; ask the pt. to repeat “ 99” or “1, 2, 3” in a clear loud voice. Decreased fremitus: sof t voice, thick chest wall, obesity or underlying diseases: COPD, pleural effusion, fibrosis or tumor. Increased fremitus occur with fluids in the lungs or infection