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Chapter 29
Assessment of the
Respiratory System
Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
Anatomy and Physiology Review
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Upper respiratory tract
Lower respiratory tract
Lungs
Accessory muscles of respiration
Respiratory changes associated with aging
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Functions of the Respiratory
System
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Respiratory Membrane
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Respiratory Mucosa
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Role of the Respiratory System
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Patient History
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Collect history of patient data on family, personal,
smoking, drug use, allergies, travel, place of
residence, dietary history, occupational history,
and socioeconomic level.
Pack-years of smoking—number of packs
smoked per day multiplied by the number of years
the patient has smoked.
Assess current health problems such as cough,
sputum production, chest pain, and dyspnea.
Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Patient History (Cont’d)
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Drug use
Allergies
Travel and geographic area of residence
Nutritional status
Cough, sputum production, chest pain,
dyspnea, PND, orthopnea
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Physical Assessment
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Assessment of the nose and sinuses
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Physical Assessment (Cont’d)
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Assessment of the pharynx, trachea, and
larynx
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Physical Assessment (Cont’d)
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Assessment of the lungs and thorax
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Physical Assessment (Cont’d)
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Assessment of the lungs and thorax
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Other Indicators of Respiratory
Adequacy
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Clubbing
Weight loss
Unevenly developed muscles
Skin and mucous membrane changes
General appearance
Endurance
Elsevier items and derived items © 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
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Psychosocial Assessment
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Some respiratory problems may be
worsened by stress.
Chronic respiratory disease may cause
changes in family roles, social isolation,
and financial problems due to
unemployment or disability.
Discuss coping mechanisms and offer
access to support systems.
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Laboratory Tests
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Blood tests
Sputum tests
Radiographic examinations including
standard chest x-rays, digital chest
radiography, CT
Ventilation and perfusion scanning
Pulse oximetry
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Pulmonary Function Testing
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These tests evaluate lung volumes and
capacities, flow rates, diffusion capacity,
gas exchange, airway resistance, and
distribution of ventilation.
Patient preparation.
Procedure for performing tests at the
bedside.
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Other Testing and Follow-Up Care
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Exercise testing
Skin testing
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Other Invasive Diagnostic Tests
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Endoscopic examinations
Thoracentesis—aspiration of pleural fluid
or air from the pleural space:
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Patient preparation for stinging sensation and
feeling of pressure
Correct position
Motionless patient
Follow-up assessment for complications
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Thoracentesis
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Lung Biopsy
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Performed to obtain tissue for histologic
analysis, culture, or cytologic examination.
Patient preparation.
May be performed in patient’s room.
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Lung Biopsy (Cont’d)
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Follow-up care:
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Assess vital signs and breath sounds at least
every 4 hr for 24 hr.
Assess for respiratory distress.
Report reduced or absent breath sounds
immediately.
Monitor for hemoptysis.
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