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NURS612 Key Points to Review for Exam 2- V2-2022

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Key Point to Review – Chest / Lungs STUDENT NOTES What are examples of appropriate history of present illness questions you may ask a patient with a chief complaint of a respiratory issue? • Do you have a cough? • Is ...

Key Point to Review – Chest / Lungs STUDENT NOTES What are examples of appropriate history of present illness questions you may ask a patient with a chief complaint of a respiratory issue? • Do you have a cough? • Is your cough sudden, gradual? • What is the duration of your cough? • Please describe your cough. Is it dry, moist, wet, hacking, hoarse, barking, whooping, bubbling, productive, nonproductive? • Do you have sputum when you cough? What does the sputum look like? Clear, purulent, blood-tinged, mostly blood, foul odor? • How often do you cough? Occasional, regular, paroxysmal? • Are you your cough related to time of day, weather, activities like exercise, talking, deep breaths, or change over time? • Does your cough disrupt your sleep or conversation? Does it cause chest pain? • Do you have any associated symptoms? Like shortness of breath, chest pain or tightness with breathing, fever, nasal congestion, noisy respirations, hoarseness, gagging? • Have you been taking in medication to treat your symptoms, over the counter medication, prescribed medication, or vaporizers? Describe how you would inspect the chest. How do you describe the size shape (A/P diameter) and symmetry of the chest? What are the thoracic landmarks? • Inspect the chest from the front and back. 1. Assess its size and shape. The anteroposterior diameter (AP) is ordinarily less than the transverse diameter. AP diameter is expressed in thoracic ratio. The AP diameter is shorter than the lateral diameter, ex: 1:2 2. Check for symmetry. You can use one side to compare with the other. 3. Consider the thoracic landmarks and observe the costal angle, angle of the ribs and intercostal spaces. 4. Note the color of the skin, noting any cyanosis or pallor. 5. Check for supernumerary nipples. 6. Look for superficial venous patterns, which may signal a cardiovascular disease. 7. Observe the prominence of the ribs as a clue to general nutrition. • Thoracic landmarks: anterior thorax, right lateral thorax, posterior thorax CONTINUED........

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