RLE 15

• The Muddiest Point in today’s session was not clear.
• Common or concerning symptoms of the respiratory system include shortness of breath, wheezing, cough, blood streaked sputum or haemoptysis or purulent sputum, and chest pain.
• When assessing the posterior chest, the starting point for counting ribs and intercostal spaces is the 6th rib.
• Increased transmission of voice sounds over the right lung indicates that the lung is overinflated.
• Dyspnea, an uncomfortable awareness of breathing that is inappropriate to the level of exertion, is referred to as air hunger.
• When fluid or solid tissue replaces air-containing lung or occupies the plural space, resonance is replaced by dullness.
• A 25-year-old male patient is brought to the emergency department by ambulance after being involved in a motor vehicle accident with decreased breath sounds over the left lung fields.
• The 11th and 12th ribs are considered "floating ribs".
• A patient with a history of chronic bronchitis might have associated symptoms such as orthopnea, chronic productive cough, paroxysmal nocturnal dyspnea, recurrent respiratory infections, and wheezing.
• The trachea bifurcates into its mainstem bronchi at the suprasternal notch when assessing posteriorly.
• The instructor should discuss the anatomy of the chest walls and the structures within, and review the health history of the patient.
• Dyspnea, wheezing, cough, and hemoptysis usually point to a respiratory problem, but they may also indicate a cardiac condition.
• Chest pain may be caused by cardiac, respiratory, gastrointestinal, or musculoskeletal ideologies.
• The initial history questions should be as broad as possible, and the nurse can utilize OLD CART mnemonic to ask follow-up questions in order to obtain a full description of the condition.
• Dyspnea is air hunger, a nonpainful but uncomfortable awareness of breathing that is inappropriate to the level of exertion, commonly termed shortness of breath.
• The disease process that would be suspected in this situation is chronic lung disease.
• The woman experiences a sudden onset of dyspnea without pain.
• An 80-year-old Hispanic woman is 48 hours postop from the repair of a fractured hip.
• Dyspnea can result from pulmonary or cardiac disease.
• The review of anatomy of chest walls is identified and the structures are discussed with detailed illustrations.
• Palpation has potential uses for identification of tender areas, assessment of observed abnormalities, assessment of chest expansion, and assessment of tactile fremitus.
• Percussion normally reveals resonance over symmetric areas of the lungs.
• Adventitious breath sounds are extra or adventitious breath sounds that are superimposed on the usual breath sounds.
• Auscultation is the most important examination technique for assessing airflow through the tracheobronchial tree.
• A Peak flow meter assesses the maximum volume of air expelled from the lungs during a vigorous exhalation.
• Check for understanding involves answering 10-15 questions that can enhance critical thinking skills.
• High impact facts and tables are important health information that should be known by healthcare professionals.
• Detection of adventitious breath sounds includes crackles, rales, wheezes, rhonchi, stridor, pleural friction rub, and mediastinal crunch or Hamman sign.
• Auscultation involves listening to the sounds generated by breathing, listening for any adventitious or extra sounds, and if abnormalities are suspected, listening to the sounds of the patient’s spoken or whispered voice as they are transmitted through the chest wall.
• Together with the percussion, auscultation also helps the nurse assess the condition for the surrounding lungs and pleural space.
• Inspection of the anterior chest involves observing the shape of the patient's chest and movement of the chest wall, noting deformities or asymmetry of the thorax, work of breathing, bruising or other skin lesions.
• Pulse oximetry measures the arterial oxygenation saturation, or SpO2, and is used to assess the health of the patient.
• Auscultation involves listening to the chest anteriorly and laterally as the patient breathes with open mouth, more deeply than normal, comparing symmetric areas of the lungs, using the pattern suggested for percussion and extending it to the adjacent areas as indicated, and identifying any adventitious breath sounds.
• Percussion involves comparing the heart's area of dullness to the left of the sternum from 3rd to 5th intercostal spaces and percussing the left lower lateral to it, identifying any area of abnormal note.
• Health promotion and counselling involves discussing health issues with the patient, providing health education, and offering health advice.
• The thorax houses several organs and structures, and the nurse must use astute questioning to ascertain the patient's problem.
• The nurse can utilize OLD CART mnemonic to ask follow-up questions in order to obtain a full description of the condition.
• Posteriorly, fremitus is generally equal throughout the lungs fields.
• On palpation of the posterior chest, there should be no tenderness; chest movement should be symmetric and without lag or impairment.
• Learn to identify FIVE PERCUSSION NOTES.