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Pulmonary Focused

Pulmonary Focused Assessment

Introduce yourself, explain to the patient what you will be doing. Provide Privacy, wash hands, raise the bed to a comfortable working level.
Start by inspecting the thorax configuration, paying attention to any barrell shape or curvature.
Inspect the breathing pattern and inspect respiratory rate, rhythm & effort (nostrils flaring, pursed lip, use of accessory muscles)
Observe the skin and nails (for clubbing & capillary refill)
Palpate by testing for symmetry of chest expansion.
Place hands on back, starting at the top and placing hands in two other places, each time having the patient say "99" to check for fremitus.
Evaluate the excursion
Auscultate bronchial breath sounds (over trachea)
Ausculate vesiclar breath sounds (in 6 spaces, working in a zig-zag motion, posteriorly & anteriorly)
Note any abnormal breath sounds (crackles, fine wheezing, coarse wheezi (rhonchi), pleural friction rub
Make sure the patient is comfortable, lower the bed, raise the rails, and put the call bell in reach & wash hands.
Document the procedure.
Created by: jessicaspring