components of a respiratory assessment
-tobacco pack per year Hx
-occupational Hx: some jobs have increased risk for resp
disorders
-sputum production
-SOB, dyspnea, cough, anorexia, weight loss, chest pain
-oral and inhalant resp meds: do they know how to take
the inhalant meds
,-OTC drugs
-allergies: meds and environmental
-last CXray and TB screen
compliance
-stretch determined by recoil/elasticity
-disease states like pulm fibrosis, ARDS, pulm edema,
COPD: lungs are less elastic
-pts must generate more work of breathing, more at risk
for resp failure, uses a lot more energy
-affects vent settings!!!
lung volume vs lung capacity
-volume: amount of air for inhalation or exhalation
-capacity: how much air can be inhaled from end of
maximal exhalation
,inspection resp assessment
-head, neck, fingers, chest, accessory muscles, sternal
retractions, nasal flaring, asymmetrical chest mvmnt,
open mouth breathing, gasping breaths
-assess rate and depth and altered patterns
percussion resp assessment
-resonance: normal lung sound
-dullness: denser than normal tissue
-flatness: air is absent
, -hyperresonance: increased amount of air
-tympany: air filled area
auscultation resp assessment
-assess breath sounds, presence of adventitious lung
sounds, voice sounds
-quiet environ
-systematic approach
cheyne stokes breathing
-cyclical w apneic periods
-CHF and NS disorders
kussmaul's breathing
-deep, reg, rapid without pauses
-DKA and other metabolic acidosis
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