NURS 550: WEEK 3 STUDY GUIDE

THORAX AND LUNGS 1. Identify the questions you need to ask in a respiratory review of systems (pages 12-13 in Bates’) a. Have you ever had any…? i. Cough ii. Sputum (color, quantity; presence of blood or hemoptysis) iii. SOB (Dyspnea) iv. Wheezing v. Pain with a deep breath (pleuritic pain) vi. Last chest x-ray 1. You may wish to include asthma, bronchitis, emphysema, pneumonia & TB 2. Describe the questions you would ask a patient presenting with the following a. Shortness of breath i. Have you had any difficulty breathing?” ii. Find out if the symptoms occur at rest or with exertion iii. How much exertion produces onset? iv. Make every effort to determine its severity based on the patient’s daily activities 1. How many flights of stairs or steps can the patient climb before pausing for breath? 2. What about carrying bags of groceries, vacuums, and making the bed? 3. Has SOB altered the pt’s lifestyle & daily activities? How? 4. Carefully elicit timing and setting, any associated symptoms, and relieving or aggravating factors v. Most patient’s related SOB to their level of activity 1. Anxious patients present a different picture 2. May describe difficulty taking a deep breath 3. Smothering sensation with the inability to get enough air 4. Paresthesiassensations of tingling or “pins & needles” around the lips or extremities b. Wheezing i. Have you noticed any musical sounds when you breathe? ii. Wheezing occurs in partial lower airway obstruction from secretions and tissue inflammation in asthma or a foreign body c. Cough i. Establish the duration 1. Acute lasting less than 3 weeks