The Respiratory System. Thorax and Lungs Rachel S. Natividad, RN, MSN, NP. Lobes and Landmarks. Inspection… …Always first!!! The moment you see the patient. What position is most comfortable for him? Does he appear relaxed, anxious, uncomfortable? Is he having any trouble breathing?.
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Thorax and Lungs
Rachel S. Natividad, RN, MSN, NP
The moment you see the patient.
What position is most comfortable for him?
Does he appear relaxed, anxious, uncomfortable?
Is he having any trouble breathing?Assessment begins….
Assymetrical chest expansion
paralysis of the diaphragmAsymmetrical chest
Retractions – indicates respiratory distress
greater than 160 degrees
Crepitus – SQ air pockets
indicates air is leaking from the airways or lungs
Tactile fremitus – a palpable vibration that is caused by the trasmission of air through the bronchopulmunary system.
increased with fluid accumulation
Abnormal if tumor,
fractured ribs, chest
tubes, wound site, fluidFocused Assessment Cont.:Palpation
Pleural friction rubAdventitious/AbnormalBreath Sounds (T 11-2) p.132
Heard 1st in expiration
Sonorous wheeze (rhonchi)
Heard primarily in expiration
Stridor- partial airway obtruction
viral croup, laryngeal or tracheal obstruction, epiglotottis