Goines “The primary purpose ofthe respiratory system is twofold: gas exchange, ‘or the raster f oxygen ane! carbon dioxide between the atmosphere ‘and the blood, and (2 the maintenance of acid-base balancs. | Respiratory Assessment 00 Inspection Inset or ably to baste, raptor te, contour and movement of (ietand petanon of evsctone Eedise tne otanenetoe by apectng sin colle of consumes codencnona sate = Sears poate of aches Aas bond ape of chaste rt > rcpt aetr Etemrane eee eq epmaenel mecha? {ipspet or cea wal efores *"Bhoets caus of the apie - anton poeteror + ites smn te tre seat + Boalt dnl hand apse normal chon salt hyperstoson sso COPD, echo ecco sr sky fi the chet + ecu carnetu stern promaing wom he chest + Evaluate for signe of respiratory distros: Sguncae. Blah Socket ofa and mucous embranes due to Senor acetone racedtinrmaein etree + purredip breathing used totncente od exptoy posse 1 Eeastoy mde thet lsng shoes: cand febochons with + diaphragmatic paradox: the diaphragm moves opposite ofthe normal drecson on mapreeo: suspect fal opment h tara, + iron rovoconsrocton of the fret sacs fom Shnormaly igh nega pressure genase rng wapton + Esai breathing patterns ai "te pea normal (12-20 brash par mina) tachypnes = incressed rate rae ‘creased rate + depth: “Fypernes~ increased depth, no changin ate ‘porenttaion = ieeased dopt and ate “hypovendlon = decreased depth and rte vse prolonged ges aggrste-poonsed ssine ama a sath tinh TE ah Ueki ee er teed 2opth and vee wot abe pen natn Rattner ns, es: spina onan Sioa arama ena i po «One wetness act kis enn ep nec ca Bd tin fad Serceererstiey tac tency omanen cies dada be al Se three se ey econ 1 Soteepa ees shoes otrenioes Sr eles tn Fe pty ecleregr hed a «inte tala rials ne aca neg ne Fo eigen pg peta pd Pan eee cae cea am sok sor oe gel ne Eefonrder le pein eel natin ores Gore «tous srt pl al oe pecs Perse etein funding eu filed wth or eter ben, ears cea eee oe cerarenunaa xacnannpamnsn, ciple nel npea uplemesomaloecan resonance orm ‘healthily aiflled ung, yperesonance too much ait emphysema emess presence of fluid pleural effusion, Srsolid mass preumonia, tumor Auscutation ‘ussite to sess aie flow through he bronchial ree Wick supair to nferior and compare ight to le ‘AStnuts postanor chest then sneer shes? = Sueultate the trachea ining the claphraom ofthe stethoscope: sound heard bronchi a + Sistltate the primary bronchi fom 310 T5) using the aophrag of Seth sovad hors bronchoveselar = ” + Sinclte the lings, begin st the apex ofeach lung (C7) and Goad tamees artnet rote w ta Corte aie ot ‘saving of te tethoncope: soars her re vesicular breath sound + Compare te sound boing Fara withthe expocted sound at hat location arti to tty adeerticu sounds Se Sanaa Seay “Tracheal breath sounds ore Heo! over the troche they ave harsh feta Seascerse tener va ok ‘near the 2rd and Sd intercostal spaces; ese sounds ae More tbl Shiatincenmtaracnetat oe a eee a onnae na pean Spee ease Se mec pene ie ey ce ame es el ‘Nosicular sounds se sof blowing/rusting seunde normaly heard roughout most of the lng felde these sounds aro normaly heard {roughowt inspiration contrue wrtout pause tough exprston, Phd thon fade suay about one-third of the way through sxpiration + Abnormal breath sounds chile the absence of sound cr the presence of normal sounds nasa whore thay sre nvm nat heard PRdvontitious breath sounds refer to extra, oF adds), sounds Mat ‘re haard ver nowmal broth sounde + Soto of govt source arimporane part ofthe reapratory ox: Smnation, cn ncing to agnoas of crc and purnorayconceore + Crackle (rales ae Sausod oy fuidn tho smal stays, atelectasis erokles oe refered to 98 diacontnuous sour they are inermi- tent, non musical and brief = Cracies may be hesrd an inspiration or expiration the “sounds they produce ore crested when i i forced ‘Brough reaatarypossages thot re narowed by Bud mucus Or pus Etncies sre often sasocnted wth inflammation or fection of te Small bronch, bronchioles and shel ~epchns that don't clear afters cough may indicate pulmonary ‘edema oF fuld nthe aiveo! due to heart failure or adult respira {ory cstress syndrome (ARDS) crackles are often described as fine, medium and coerse Stine erackles se sof, high-pitched and very bret (imulote ths sound byroling a svand of hs between your fingers near your eat bry motstening your thunk and index finger and separating them rearyour 23) ame es > coarse erackles sre somewhat louder lower in itch anc! or farting than fine crackin, they have been deserbed os sounding ite opening aver fastener “aca rcs eben es conn cin an atin + wheezes sre eaused by ai moving through airways. narrowed by onstrcton or swoling of away or by paral airway obstruction ‘wheezes are sounds that are heard continuously during inepration fr expiration, ar during bath iepraton and exsiraton wheezes that are relatively high pitched and have a svi or squeak ing quality may be referred to at sblant thonch there sounds are often heard continuously through both inpration and expation, Sd have » musical qualty; hese wheezes occur wien aiteays are havrowed, such as may occur during an acute asthmatic ata Wwheezes that are lower pitched sounds, wth @ snoring or moaning {Qalty, may be referred to a sonorous rhonchi secretions n large always, ach 98 occur with bronchitis, may produce these sounds which may dear somewhat with coughing + plourl friction rubs are low-piched, grating or creaking sounds that oe pe tere seer oitace St tepid dred opener more often heard on inspiration than expration the pleural fiction rub 2 percanalcion ns to detemine whether the sound aplewal icon rab of 8 percardal Frtion rub, ack te cient to hold hither breath brief. te rubbing Scud continuos 1's» perteardal retin rub because to om percardal ayers conte nsbingtopeter ity each hearts pleural fiction rub stops whan breathing stops + ede oso ices ean ea cing npetion ‘trdor i eaueed by obstruction of the upper airway te 9 sign of Fespiratory distress, and thus, squires immediate attention Gor ‘The breast examination ie a ertical part of the aseeeement. + Inspedt for smoothness, dipling and color 2 Obterve for edema ani symmety of sie * Observe for nipplo inversion or discharge {Palpete in concentric eles, noting tau consistency (sot, fm, hora) *Palpste areola and nipple, then gently compress nipple and observe fordlacharge + Palpate axilary lymph nodes ula of the eile lowest sh fot tive for ho are