Questions and Answers
A client has a history of emphysema. The nurse percusses the chest, expecting to find which of the following?
If abnormalities are noted during lung auscultation, what should the nurse do first?
Have the client cough, then listen again.
What thorax or lung disorder is most likely causing symptoms in a 62-year-old construction worker with a chronic cough and shortness of breath?
Chronic obstructive pulmonary disease (COPD)
While assessing the health of a client's respiratory system, what instruction should the nurse provide to assess fremitus?
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What disease process should the nurse suspect in a client who is 48 hours postop from hip repair and has sudden dyspnea without pain?
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What action by a nurse demonstrates the proper sequence for auscultation of the lung fields?
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Study Notes
Hyperresonance
- Hyperresonance indicates air trapping, often observed in clients with emphysema.
- Dullness signifies fluid or solid tissue replacing lung air.
- Normal lung percussion results in resonance.
- Tympany is detected over air-filled structures, such as the stomach.
Lung Auscultation
- After detecting abnormal lung sounds, the nurse should have the client cough and listen again for changes.
- Coughing may help clear the lungs of abnormalities.
- Persistent sounds after coughing indicate the need for further evaluation.
- Auscultation of voice sounds is part of a comprehensive thorax assessment.
Chronic Obstructive Pulmonary Disease (COPD)
- COPD commonly affects older adults with a history of smoking.
- Patients often exhibit an enlarged chest diameter resembling a barrel.
- Hyperresonance is noted on percussion, distant breath sounds may be present during auscultation.
- Rhonchi, or coarse breath sounds, may be audible.
- Quantifying exercise capacity is crucial for managing the disease and understanding its impact on employment.
Fremitus Assessment
- Fremitus assessment involves palpating for vibrations transmitted through the bronchial tubes to the chest wall.
- Clients should be instructed to say "ninety-nine" during palpation to enhance vibration detection.
Pulmonary Embolism
- Risk factors for pulmonary embolism include postpartum or postoperative recovery, prolonged bed rest, congestive heart failure, chronic lung disease, hip or leg fractures, and deep venous thrombosis.
- Sudden onset dyspnea in a patient after hip surgery may indicate pulmonary embolism.
Auscultation Technique
- Proper auscultation of lung fields involves listening for a complete respiratory cycle at each site.
- Clients should be instructed to breathe deeply through the mouth during auscultation.
- The sequence should start from the anterior to the posterior side to ensure no areas are missed.
- The bell is not utilized for breath sounds, as it is designed for low pitched sounds like abnormal heart sounds.
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Description
This quiz focuses on the thorax and lung assessment, particularly hyperresonance in clients with emphysema. Test your knowledge on percussion findings and respiratory assessments related to lung conditions. Ideal for nursing students and healthcare professionals.
