10 Questions
What is the term for the inward curvature of the thoracic spine, often associated with osteoporosis?
Kyphoscoliosis
What is the purpose of percussing the thorax during a respiratory examination?
To determine the tissues filled with air, fluid, or solid material
What is the term for the high-pitched sounds heard during inspiration in the lungs?
Crackles
What is the term for the inability to breathe easily except in an upright position?
Orthopnea
What is the purpose of auscultating the thorax during a respiratory examination?
To evaluate the presence of fluid or solid obstruction in the lung structures
What is the primary purpose of inspecting the external nose during a nursing assessment?
To identify lesions or asymmetry
What is the purpose of using a tongue blade during a nursing assessment of the pharynx?
To depress the tongue and visualize the pharynx
What can cause displacement of the trachea?
Masses in the neck or pleural or pulmonary disorders
What is a type of chest deformity that can be observed during a nursing assessment of the thorax?
Barrel chest
What is an example of a psychosocial factor that may be assessed during a nursing assessment of patients with pulmonary disorders?
Family relationship
Study Notes
Kyphoscoliosis and Breathing Patterns
- Kyphoscoliosis: characterized by an S-shaped curved spine, often seen in conditions like osteoporosis
- Breathing patterns: assess rate and depth of respiration, looking for signs of tachypnea, hyperpnea, hyperventilation, Kussmaul respiration, and Cheyne-Stokes respiration
Palpation and Percussion
- Palpation: assess thorax for tenderness, masses, and lesions
- Percussion: used to determine the type of tissue (air-filled, fluid-filled, or solid), identify dullness over the lung (e.g., lobar pneumonia), identify tympanic sound (e.g., pneumothorax), and identify type of resonance (e.g., emphysema)
Auscultation
- Auscultation: used to assess flow of air through bronchial tree and evaluate presence of fluid or solid obstruction in lung structures
- Abnormal breathing sounds: crackles (soft, high-pitched sounds during inspiration), wheezing (deep, low-pitched sounds during expiration), and pleural friction rub (harsh, crackling sound during inspiration and expiration)
Abnormal Breathing Patterns
- Dyspnea: difficulty breathing
- Orthopnea: inability to breathe easily except in an upright position
- Cough: resulting from irritation of mucous membranes in respiratory tract, often due to infectious process or irritants like smoke, dust, and gases
Nursing Assessment of Upper Respiratory System
- Nose and sinuses: inspect and palpate for lesions, asymmetry, or inflammation
- Pharynx: inspect for color, symmetry, exudates, ulceration, or enlargement using a tongue blade
- Trachea: assess position and mobility by direct palpation and coughing response, noting any deviation due to masses in the neck or pleural or pulmonary disorders
Nursing Assessment of Patients with Pulmonary Disorders
- Health history: ask about reason for seeking healthcare, including dyspnea, pain, wheezing, hemoptysis, and other symptoms
- Contributing factors: assess smoking history, personal or family history of lung disease, occupational history, and exposure to allergens and environmental pollutants
- Psychosocial factors: assess anxiety, role changes, family relationships, and financial and employment problems
Test your knowledge on the examination process for the nose, sinuses, pharynx, and trachea in nursing assessment. Questions may cover topics such as inspection, palpation, and identification of abnormalities in these upper respiratory system structures.
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