Case Study: The Respiratory System

1. A nurse is managing the nursing care an adult patient with a history of

respiratory issues. The educational component of the care includes providing
the patient with information regarding the purpose and execution of a
respiratory examination. Other topics to be discussed include risk factors for
respiratory disease and health promotion strategies to reduce the patient’s
current risks. (Learning Objectives 8, 11, and 12)

a. What information and instructions should the nurse include in the

patient’s education information regarding the upcoming respiratory
examination?

 ANSWER: The nurse should include the following information and

instructions in the patient’s education information regarding the
upcoming respiratory examination:
o Explain the following to the patient being careful to define
the bold words:
 Examination of the posterior thorax and lungs will
occur while the patient is sitting
 Examination of the anterior thorax and lungs with
the patient supine
 Inspection
 Palpation
 Percussion
 Auscultation
 For men the chest is fully visible
 For women the anterior chest will be covered when the
back is examined. For the anterior examination, the
gown will be draped over the half of the chest that
isn’t being examined

b. What areas should the nurse address when discussing risk factors for
respiratory diseases?
o ANSWER: The nurse should address the following areas when
discussing risk factors for respiratory diseases:
o 65 years and older
o Chronic illnesses
o Tobacco smoking
o Immunosuppression
o Pneumococcal pneumonia
 c. What risk deduction and health promotion strategies should the nurse
include when educating this patient?

ANSWER: The nurse should include the following risk deduction and health
promotion strategies when educating this patient:
a. Smoking cessation, if applicable
b. Immunizations for influenza and pneumococcal pneumonia

2. A patient has been admitted from the emergency department with a

large pleural effusion caused by untreated pneumonia. (Learning
Objectives 7 and 11)

a. Define pleural effusion for this patient as you educate them about
their condition.

ANSWER: Pleural effusion is when excessive fluid accumulates because

the body does not handle fluid properly. The fluid in pleural
effusions also may result from inflammation, such as in pneumonia
(which relates to this patient specifically).

b. Compare and contrast assessment data findings indicative of

pleural effusion.
ANSWER: b. Assessment data findings indicative of pleural
effusion may induce:
 Lateral displacement of the trachea toward the unaffected
side may be seen in pneumothorax, pleural effusion, or
atelectasis.
 Unilateral decrease or delay in chest expansion include
pleural effusion, lobar pneumonia.