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NUR 568 Week 8 Thorax & Lungs Test With Complete Solution
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NUR 568 Week 8 Thorax & Lungs TestWith Complete Solution
Concepts on performing exam - Assess for? - ANSWER assess for dyspnea,
cough, hemoptysis and chest pain.
Exam sequence - ANSWER Inspection, Palpation, Percussion, Auscultation
Initial Observations - ANSWER observe rate, rhythm, depth, effort of
breathing; listen for audible breath sounds. Observe posture, position and
ability to speak in full sentences.
Physical Exam - ANSWER Appropriate Draping
Palpation - ANSWER anterior and posterior chest wall, spine, and area of
bruising
Percussion - ANSWER used in diaphragmatic excursion, resonance will
change throughout fields d/t placement of heart
Auscultation - ANSWER differentiate between normal, abnormal and
transmitted breath sounds
Normal Lung Sounds - ANSWER tracheal, bronchovesicular, vesicular
Tracheal lung sounds - ANSWER loudest and highest pitched, 1:1 inspiratory
to expiratory ratio
Bronchial lung sounds - ANSWER louder and higher in pitch, 1:2 ratio, heard
over bronchial areas (upper chest)
Bronchovesicular lung sounds - ANSWER intermediate intensity and pitch;
, 1:1 inspiratory to expiratory ratio
Vesicular lung sounds - ANSWER Soft intensity, low pitched. Heard over the
entire lung field except over the upper sternum and between the scapulae.
3:1 ratio of inspiratory to expiratory ratio.
Crackles - ANSWER fine or coarse; fine are discontinuous high-pitched
sounds that have a popping quality, usually inspiratory; coarse are
discontinuous, low-pitched, louder and longer.
Wheezes - ANSWER continuous musical sounds that can be high or low
pitched. Wheezing is usually heard during expiration but may be heard
during both inspiration and expiration.
Rhonchi - ANSWER when larger airways are obstructed with secretions,
continuous low-pitched rattling sounds, called rhonchi, are heard. May mimic
snoring.
Stridor - ANSWER loud and high-pitched sound caused by disrupted airflow,
typically during inspirations and associated with upper airway obstruction.
Emergency!
Pleural Rubs - ANSWER creaking or grating sound that can be heard during
both inspiration and expiration as a result of friction between pleura.
Pediatric Lung Differences - ANSWER Peds will have barrel chest
presentation, little structural support from ribs. Upper airway sounds may be
transmitted to lower. View with just a diaper on to assess respiratory effort.
Geriatric Considerations - ANSWER atypical presenations for pneumonia
ABCDEF Neumonic for chest x-rays - ANSWER airway, bones, cardio
mediastinal silhouette, diaphragm, expanded lungs, everything else, foreign
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