Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar
Web: http://uep.edu.ph Email: uepnsofficial@gmail.com

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

Assessing Thorax and Lungs

Current Symptoms

1.Diffidulty breathing (at rest, with specific activities, while sleeping.

Other symptoms when having trouble breathing)?
2.Chest pain associated with a cold fever or deep breathing?
3. Cough, with or without sputum?

Past History
1.Prior respiratory problems?
2.Previous thoracic surgery, biopsy, or trauma
3. Allergies, symptoms/treatments?
4. Pulmonary studies/tests: chest x-ray,B skin test, or influenza
immunization?

Family History
1. Family History of Lung disease?

Life style and Health Practices

1. Use of tobacco products, cigarettes or Cigars (number of years,
number per day)?
2. Exposure to environmental conditions that the effect breathing at
work or at home, including second hand smoke?
3. Difficulty performing usual daily activities?
4. Degree of stress, effect on breathing?
5. Medications for breathing (prescribed or OTC). Other breathing
treatments?
 Republic of the Philippines
UNIVERSITY OF EASTERN PHILIPPINES
University Town, Northern Samar
Web: http://uep.edu.ph Email: uepnsofficial@gmail.com

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

PERFORMANCE EVALUATION CHECKLIST

ASSESSING THORAX AND LUNGS
Able to Able to Unable
Perform Perform with To
PROCEDURE (2) Assistance Perform
(1) (0)
Current Symptoms
1. Gather equipment (gown and drape, gloves, stethoscope, exam
light, mask skin marker, metric ruler).
2. Explain the procedure to client.
3. Ask the client to put on a gown.
Posterior Thorax
1. Inspect for shape and configuration of the chest wall and
position of scapulae.
2. Inspect for use of accessory muscles.
3. Inspect the client’s positioning noting Posture and ability to
support weight while breathing.
4. Palpate for tenderness and sensation with gloved finger.
5. Palpate for surface characteristics such as lesions masses with
gloved fingers.
6. Palpate for fremitus, using the ball or ulnar edge of one hand
while the client says “ninety-nine “Assess for symmetry and
intensity of vibration.
7. Palpate for chest expansion. Place hands on the posterior chest
wall with your thumbs as the client takes a deep breath.
8. Percuss for tone, starting at the a Apices above scapulae and
across the tops of the both shoulders.
9. Percuss intercostal spaces across and down, comparing sides.
10. Percuss to the lateral aspects at the bases of the lungs and
compare sides.
11. Percuss for diaphragmatic excursion, using the procedure in
chapter 18 of the textbook.
12. Auscultate for breath sounds (normal: bronchial,
bronchovesicular, and vesicular), noting location.
13. Auscultate for adventitious sounds (crackles, fine or course,
pleural friction rub, wheeze, sibilant, or sonorous)
14. Auscultate for voice sounds over the
chest wall:
Bronchophony- ask the client to repeat the phrase “ninety-
nine”:
egophony-ask the client to repeat the letter: “E”; whispered
pectoriloquy-ask the client to whisper the phrase “one-two-
three”.
 Able to Able to Unable
Perform Perform To
PROCEDURE (2) with Perform
Assistance (0)
(1)
Anterior Thorax
1. Inspect for shape and configuration to determine the ratio of
anteroposterior diameter to transverse diameter (normally 1.2)
2. Inspect for position of sternum from anterior and lateral
viewpoints
3. Inspect for slope of the ribs from anterior and lateral viewpoints
4. Inspect for quality and pattern of respiration, noting breathing
characteristics, rate, rhythm, and depth.
5. Inspect Intercostal spaces while client breathes normally
6. Inspect for use of accessory muscles
7. Palpate for tenderness and sensation, using fingers.
8. Palpate surface characteristics such as lesion for masses, using
fingers of gloved hand.
9.Palpate for fremitus while the client say’s “ninety-nine”
10. Palpate for chest expansion by placing hands on anterolateral
wall with the thumbs along the costal margins and pointing
toward the xipoid process. Observe the movement of the thumb
as the client takes a deep breath.
11. Percuss for tone above the clavicles and then the intercostal
spaces across and down, comparing sides.
12. Auscultate for breath sounds, adventitious sounds, and voice
sounds.
Analysis of Data
1. Formulate nursing diagnoses (wellness, risk actual).
2. Formulate collaborative problems.
3. Make necessary referrals.

Remarks: _____________________________________________________________________________

_____________________________________________________________________________________

Grade: ________

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Clinical Instructor Student’s Signature