Advanced Health Assessment On Respiratory System

Advanced Health Assessment On Respiratory System Advanced Health Assessment On Respiratory System Permalink: advanced-health-…spiratory-system / Physiology of the Respiratory System A candid understanding of the physiology of the breathing system and its functions is significant. With knowledge, a healthcare practitioner can guarantee safe and effective care to the patient. The human respiratory system includes the airways, lungs, and associated organs (Belleza, 2018). Through the process of ventilation and diffusion, the human respiratory system involves the supply of oxygen into the body and the removal of carbon dioxide and other gases from the body (Belleza, 2018). Concisely, ventilation happens when gases move in (inspiration) and out(expiration) of the lungs. On the other hand, diffusion is the movement of oxygen and carbon dioxide from high concentration areas to low concentration areas (Belleza, 2018). Advanced Health Assessment On Respiratory System The lungs are the principal organs of the respiratory system with three lobes on the right and two lobes on the left (Bickley et al., 2017). Each lung covers 4 centimeters above the top rib and expands down to the twelfth thoracic vertebrae, and is covered by the pleura (Bickley et al., 2017). The lung can be located within a bony cage (thorax) consisting of 12 thoracic vertebrae, sternum, and 12 pairs of ribs (Belleza, 2018). The chest helps shield the respiratory organs and structures and additionally facilitates breathing. Another organ within the thoracic cavity is the diaphragm. The diaphragm controls breathing and intercostal muscles (Jabar & Al-Husain, n.d.). Inspiration involves a contraction of the diaphragm downwards such that the lung is filled with air. During the process, the intercostal muscles pull the chest outwards Bickley et al., 2017). During expiration, the intercostal muscle and diaphragm muscle relax; air comes from the lungs (Belleza, 2018). Air travel into the lungs through airways during inspiration. The mouth, nose, larynx, pharynx, and upper trachea, a 10-centimeter-long flexible tube, belong to the upper airways (Belleza, 2018). The upper airways allow air movement into the lower airways, protect the lower airways from foreign materials inhaled, and warms, humidifies, and filters inspired air (Jabar & Al-Husain, n.d.). The lower airways structures include the alveoli, bronchioles, bronchi, and lower trachea. The lower airways progressively become smaller until they terminate in the alveoli (Jabar & Al-Husain, n.d.). Gas exchange happens at the alveoli, primarily oxygen in and carbon dioxide out. Other functional units of the lungs where gas exchange occurs are the alveolar ducts, sacs, and alveolus (Belleza, 2018). These functional units are found within the pulmonary capillary bed. The trachea and bronchi remain to be dead space because no gas exchange takes place there (Belleza, 2018). Relevant Health History Questions Advanced assessment of the respiratory system involves a review of the standard or concerning operations. The nurse must collect information about the patient’s health history. The process starts subjective questions such as: Ensure you confirm the patient’s ID to be sure you are assessing the right person. Proceed to get information about the patient’s health history by considering the following questions: i) Does the patient have any chronic illness? ii) Does the patient have any allergies? iii) Is the patient experiencing shortness of breath? iv) Is the patient currently under any form of medication? v) Does the patient have any history of tobacco smoking, whether past or current? (Bickley et al., 2017). Focus on the past respiratory problems and diseases, injuries, or surgeries to the chest The next focus on the family history of respiratory conditions Find out if the patient is vulnerable to any environmental conditions. Does the patient have any recent international travel? Concisely, subjective assessment of the respiratory system will include looking at the following symptoms: Cough – whether the cough is hoarse, barking, productive, or nonproductive Sputum characteristics- whether it is clear, purulent, rust-colored, frothy or pink Dyspnea (shortness of breath)- which involves wheezing, stridor, with or without activity Chest pain- checked on inspiration, expiration or coughing, and location of the pain. The nurse should enquire if there are symptoms such as fever, fatigue, cold, and night sweats. In cases where the patient responds, the nurse should establish when the symptoms started. He/she should also determine the severity of the symptoms, including the location and setting of the infection (Bickley et al., 2017). Advanced Health Assessment On Respiratory System Respiratory System – Physical Examination The nurse should establish objective data and perform a physical examination by: Inspecting the patient’s general appearance, breathing effort, posture amongst others Observing the quality, patter, and rate of chest expansion or respiratory rate Examining the nails, skin, and lips for color. As a knowledge indicator, the skin should be warm and dry, and the color should be uniform and consistent. Measuring the oxygen saturation level Focusing on the posterior and anterior thorax establishes a symmetrical shape and extends that to palpation to develop tenderness and bulges (Flenady et al., 2017). Percussing the lateral thorax for tone Palpating the trachea for the position. Special Assessment Techniques for The Respiratory System During the respiratory assessment, special assessment techniques are applicable: Palpation for thoracic expansion Palpation means using your hand to feel the size, texture, and consistency of the pulse from different parts of the body (Bickley et al., 2017). The right way to perform palpation is to stand behind the patient and place thumbs on the side of the client’s spine (Bickley et al., 2017). An extension of the fingers outwards across the posterior chest wall is e key (Flenady et al., 2017). The movement of the thumb should remain equally lateral as the client takes several deep breaths under the instruction of the nurse (Bickley et al., 2017). Whenever there are any unequal movements, then it is a sign of problems within the respiratory system. Percussions This technique involves the posterior and lateral thorax. The nurse is expected to strike their finger against the chest wall of the client. Listen carefully to the sound that emerges (Bickley et al., 2017). Palpation of the posterior thorax This technique involves assessing the thorax to establish the respiratory level. During this technique, a nurse should ask the patient to verbalize (Bickley et al., 2017). Adapting Techniques to Specific Populations While undertaking a physical examination of the patient, the nurse should note the age-related differences in patients. Infants- A crying child or infant makes it difficult to produce accurate data. Therefore, a child or infant should be calm before respiratory assessment starts (Liu et al., 2016). Geriatric population – In the case of the geriatric population, the nurse should focus on the structural problems that come with age. At old age, structural problems make the thorax expansion a bit difficult and painful (Bickley et al., 2017) . Pregnancy – pregnancy as special conditions cause several adjustments in women. In some cases, it may cause some discomfort, such as fatigue, dizziness, and breathing difficulty (Bickley et al., 2017) . Thus, a nurse needs to put all these into considerations. The signs of discomfort may be so profound if the woman has other pre-existing conditions. Diseases that May Impact Respiratory System There are many diseases or disease processes that may impact the pulmonary system. These include acute bronchitis, tuberculosis, pleural effusion, asthma, emphysema, chronic bronchitis, amongst others (Bickley et al., 2017) . This paper’s focus is pneumonia because it is the most prevalent as per the current world epidemic. Pneumonia starts from an infection that causes inflammation of the air sacs (Bickley et al., 2017) . Because the air sacs are filled with puss, the patient may experience chills, fever, coughs, and breathing difficulty (Bickley et al., 2017) . The disease is life-threatening, especially to infants, young children, and the elderly of 65 years and above. Advanced Health Assessment On Respiratory System Expected Abnormal Physical Examination Findings Several abnormal physical findings can be found in a patient in the process auscultation. Some of the strange results are synthesized and discussed in the table below: Abnormality Description Byadypnoea The abnormality is a result of less than ten breathes per minute despite smooth respiratory rhythm and depth. Hyperventilation Characterized by the rapid respiratory rate that is very deep and difficult; also known as Kussmaul breathing Air trapping The patient exhibits prolonged, forced expirations, and rapid inspirations. In most cases, the patient may have the obstructive pulmonary disease (Liu et al., 2016). Stridor Characterized by sharp and high-pitched sound as a result of inflammation in the laryngeal regions. Wheeze This is a squeaking sound that occurs in inspiration or expiration due to narrow airways because of diseases like asthma. Conclusion With the significant organ being the lungs, the respiratory system ensures the body is oxygenated while also removing carbon dioxide and other gaseous waste products from the body cells. The advanced health assessment process started with a physiology of the respiratory system, an explanation of the standard procedures when collecting data on the health history and present patient status, and physical examinations of different groups of patients. Several abnormalities and diseases affect the respiratory system, including pneumonia, lung cancer, and many more. Because of its sensitivity, nurses should primarily assess the respiratory system accurately and comprehensively. References Bickley, L., Szilagyi, P., Hoffman, R., & Bickley, L. (2017). Bates’ pocket guide to physical examination and history taking (12th ed.). Wolters Kluwer/Lippincott Williams & Wilkins. Advanced Health Assessment On Respiratory System Belleza, M. (2018). Respiratory system anatomy and physiology – Nurseslabs . Nurseslabs. Retrieved 24 July 2020, from Jabar, A., & Al-Husain, A. (n.d.). Lab 4: Thorax assessment assess- lungs and respiratory system . Retrieved 24 July 2020, from Liu, Y., Li, H., Ding, N., Wang, N., & Wen, D. (2016). Functional status assessment of patients with COPD. Medicine , 95 (20), e3672. Flenady, T., Dwyer, T., & Applegarth, J. (2017). Accurate respiratory rates count: So should you! Australasian Emergency Nursing Journal , 20 (1), 45-47. Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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