NP Assessment Lungs & Respiratory
System
HPI - correct answer ✔Onset - When did the SOB start? What was the
individual doing when they were SOB? Is this sudden or gradual?
Location - Does the SOB cause any tightness or pain? If so, where?
Duration - How long does the SOB last? Over what period of time?
Characteristics - Are they winded? Unable to catch breath? Is there a cough
associated?
Aggravating - What actions/activities/positions make it worse? Does exposure
to smells, dust, pollen, smoke increase SOB?
Relieving - positions?
Tx - What meds/breathing tx help
Severity - 0 - 10; is there itching or swelling? anxious or fearful?
PMH - correct answer ✔Past History of illness:
Assess for significant childhood health history
Hx of asthma, bronchiolitis, pneumonia
Respiratory hospitalizations +/- intubations & surgeries
Screen young adults and adults for chronic respiratory disease history
(asthma/CF)
Do you have SOB, wheezing, worsening cough (smokers, chronic cough,
bronchitis, empysema)
COPD - assess for increased dyspnea and chronic productive cough
Any known/suspected pulmonary, cardiac, or renal disease or
travel/hospitalization/immobility
Medications:
, nebs, inhalers
Allergies -
medications, seasonal, environmental, food allergies
Immunizations -
influenza, pertussis, pneumococcal / PPD testing
Family Hx - correct answer ✔asthma, chronic bronchitis, TB, lung CA - ask
as "breathing problems"
GERD, atopy, allergies
Social History - correct answer ✔occupational and environmental exposures
substances - tobacco, ETOH, drugs, OTCs
pack years = packs per day x years
HPI - Dyspnea - correct answer ✔"Have you had difficulty Breathing"
Exercise tolerance / Dyspnea upon exertion
Are you experiencing wheezing?
Positional?
HPI - Cough - correct answer ✔Acute cough - <3 weeks
Subacute cough - 3 - 8 weeks
Chronic cough - > 8 weeks (GERD, HF, chronic bronchitis, lung CA, ACE
inhibitors)
Time of day/ exposure
Interfere with ADLs
System
HPI - correct answer ✔Onset - When did the SOB start? What was the
individual doing when they were SOB? Is this sudden or gradual?
Location - Does the SOB cause any tightness or pain? If so, where?
Duration - How long does the SOB last? Over what period of time?
Characteristics - Are they winded? Unable to catch breath? Is there a cough
associated?
Aggravating - What actions/activities/positions make it worse? Does exposure
to smells, dust, pollen, smoke increase SOB?
Relieving - positions?
Tx - What meds/breathing tx help
Severity - 0 - 10; is there itching or swelling? anxious or fearful?
PMH - correct answer ✔Past History of illness:
Assess for significant childhood health history
Hx of asthma, bronchiolitis, pneumonia
Respiratory hospitalizations +/- intubations & surgeries
Screen young adults and adults for chronic respiratory disease history
(asthma/CF)
Do you have SOB, wheezing, worsening cough (smokers, chronic cough,
bronchitis, empysema)
COPD - assess for increased dyspnea and chronic productive cough
Any known/suspected pulmonary, cardiac, or renal disease or
travel/hospitalization/immobility
Medications:
, nebs, inhalers
Allergies -
medications, seasonal, environmental, food allergies
Immunizations -
influenza, pertussis, pneumococcal / PPD testing
Family Hx - correct answer ✔asthma, chronic bronchitis, TB, lung CA - ask
as "breathing problems"
GERD, atopy, allergies
Social History - correct answer ✔occupational and environmental exposures
substances - tobacco, ETOH, drugs, OTCs
pack years = packs per day x years
HPI - Dyspnea - correct answer ✔"Have you had difficulty Breathing"
Exercise tolerance / Dyspnea upon exertion
Are you experiencing wheezing?
Positional?
HPI - Cough - correct answer ✔Acute cough - <3 weeks
Subacute cough - 3 - 8 weeks
Chronic cough - > 8 weeks (GERD, HF, chronic bronchitis, lung CA, ACE
inhibitors)
Time of day/ exposure
Interfere with ADLs
