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Chapter 29

Chapter 29. Assessment of the Respiratory System. Anatomy and Physiology Review. Upper respiratory tract Lower respiratory tract Lungs Accessory muscles of respiration Respiratory changes associated with aging. Functions of the Respiratory System. Respiratory Membrane.

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Chapter 29

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  1. Chapter 29 Assessment of the Respiratory System

  2. Anatomy and Physiology Review • Upper respiratory tract • Lower respiratory tract • Lungs • Accessory muscles of respiration • Respiratory changes associated with aging

  3. Functions of the Respiratory System

  4. Respiratory Membrane

  5. Respiratory Mucosa

  6. Role of the Respiratory System

  7. Patient History • Collect history of patient data on family, personal, smoking, drug use, allergies, travel, place of residence, dietary history, occupational history, and socioeconomic level. • Pack-years of smoking—number of packs smoked per day multiplied by the number of years the patient has smoked. • Assess current health problems such as cough, sputum production, chest pain, and dyspnea.

  8. Patient History (Cont’d) • Drug use • Allergies • Travel and geographic area of residence • Nutritional status • Cough, sputum production, chest pain, dyspnea, PND, orthopnea

  9. Physical Assessment • Assessment of the nose and sinuses

  10. Physical Assessment (Cont’d) • Assessment of the pharynx, trachea, and larynx

  11. Physical Assessment (Cont’d) • Assessment of the lungs and thorax

  12. Physical Assessment (Cont’d) • Assessment of the lungs and thorax

  13. Other Indicators of Respiratory Adequacy • Clubbing • Weight loss • Unevenly developed muscles • Skin and mucous membrane changes • General appearance • Endurance

  14. Psychosocial Assessment • Some respiratory problems may be worsened by stress. • Chronic respiratory disease may cause changes in family roles, social isolation, and financial problems due to unemployment or disability. • Discuss coping mechanisms and offer access to support systems.

  15. Laboratory Tests • Blood tests • Sputum tests • Radiographic examinations including standard chest x-rays, digital chest radiography, CT • Ventilation and perfusion scanning • Pulse oximetry

  16. Pulmonary Function Testing • These tests evaluate lung volumes and capacities, flow rates, diffusion capacity, gas exchange, airway resistance, and distribution of ventilation. • Patient preparation. • Procedure for performing tests at the bedside.

  17. Other Testing and Follow-Up Care • Exercise testing • Skin testing

  18. Other Invasive Diagnostic Tests • Endoscopic examinations • Thoracentesis—aspiration of pleural fluid or air from the pleural space: • Patient preparation for stinging sensation and feeling of pressure • Correct position • Motionless patient • Follow-up assessment for complications

  19. Thoracentesis

  20. Lung Biopsy • Performed to obtain tissue for histologic analysis, culture, or cytologic examination. • Patient preparation. • May be performed in patient’s room.

  21. Lung Biopsy(Cont’d) • Follow-up care: • Assess vital signs and breath sounds at least every 4 hr for 24 hr. • Assess for respiratory distress. • Report reduced or absent breath sounds immediately. • Monitor for hemoptysis.

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