10 Questions
What is the primary purpose of asking 'Difficulty in Breathing when sleeping?' during a thoracic and lung assessment?
To assess the use of more than one pillow
During the inspection of the thorax, what is the normal finding regarding chest symmetry?
Equal retraction
What is the normal respiratory rate in a healthy adult?
12-20/min
During palpation, which position should the client be in to assess the posterior lung and thorax?
Sitting position
Where should the pulmonic area be palpated during a thoracic and lung assessment?
In the 2nd ICS at Lt
What is tactile fremitus?
The vibration of the chest wall caused by sound vibrations from speech
What is the purpose of palpation in chest examination?
To examine lung tissue density
What is percussion used for in chest examination?
To compare the symmetry of percussion notes
What is required for auscultation during chest examination?
A diaphragm stethoscope and slow, deep breaths
What is the significance of increased tactile fremitus?
Denser or inflamed lung tissue
Study Notes
Thoracic and Lung Assessment
- Focus questions for subjective data:
- Difficulty in breathing
- Associated factors and relieving factors
- Difficulty in breathing when sleeping
- Use of more than one pillow to sleep
- Coughing (productive or not productive)
- Sputum (type and amount)
- Dyspnea or shortness of breath (at rest or exertion)
- Chest pain associated and precipitating factors
- History of asthma, bronchitis, TB
- Exposure to environmental inhalants
- Smoking
Inspection
- Inspect anterior, posterior, and lateral thorax for:
- Color (normal: pink, deviations: pallor, cyanosis)
- Intercostal spaces (normal: relaxed, deviations: bulging)
- Chest symmetry (normal: equal retraction, deviations: unequal)
- Respirations (normal: 12-20/min, rate, rhythm, depth)
- Shape (normal: normal, deviations: abnormal shape)
Palpation
- Procedure:
- Drape anterior chest and use fingers pads or palms to palpate posterior chest
- Have client fold arms across anterior chest and lean forward to expose areas of lungs
- Palpate, percuss, and auscultate posterior lung and thorax while the client is sitting
- Palpate, percuss, and auscultate lateral lungs and thorax while client is in the supine position
- Palpate pulmonic area in 2nd ICS at Lt. sternal border
- Tactile fremitus:
- Refers to the vibration of the chest wall that results from sound vibrations created by speech or other vocal sounds
- Indicates denser or inflamed lung tissue, such as pneumonia, COPD, or asthma
- Vocal (tactile) fremitus is palpation of the chest wall to detect changes in the intensity of vibrations created with certain spoken words in a constant tone and voice (e.g., 44-55-99)
Percussion
- Procedure:
- Use percussion over shoulder apex and intercostal spaces
- Compare for symmetry of percussion notes, while moving from apex to base of lungs
- Intercostal landmarks for percussion of thorax
- Technique of percussion
Auscultation
- Procedure:
- Use diaphragm of stethoscope, exert pressure over intercostal space
- Instruct client to take slow, deep breaths through the mouth
This quiz assesses knowledge on thoracic and lung assessment equipment, focusing on subjective data collection and questions related to breathing difficulties, coughing, and chest pain. It covers associated and relieving factors, as well as medical history.
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