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Respiratory Assessment Age-Related Variations: Infants, Children, and Adolescents correct
answers Assessing the respiratory status of an infant, child, or adolescent usually follows the
same sequence as for an adult, although there are a few differences worth noting
Assessing neonates and infants requires use of different equipment and an unhurried approach
Use a pediatric stethoscope when examining an infant or child. The infant must be undressed at
least to the diaper to perform an adequate assessment
Keep the infant covered when you are not performing the examination to prevent exposure and
cooling
Conduct the examination while the infant is calm if possible; examination of a crying infant is
difficult
By the ages of 2 or 3 years the child is usually cooperative during the respiratory examination
Before that age you need to develop a relationship with the child to improve cooperation during
the examination
Respiratory Assessment Age-Related Variations: Older Adults correct answers Assessing the
respiratory status of an older adult follows the same procedures as for an adult, although
structural and functional differences may be noted
,When assessing older adults, the nurse uses an unhurried approach and may find expected
variations from adults such as changes in the musculoskeletal system that affect respiratory
function
Posterior thoracic stooping or bending or kyphosis may alter the thorax wall configuration and
make thoracic expansion more difficult
Respiratory variations in infants and children correct answers 1. Young infants rely on the
diaphragm and abdominal muscles for breathing; the chest wall is thinner and more flexible.
2. The respiratory rate is faster in newborns, infants, and young children.
Respiratory variations in older adults correct answers 1. Diminished strength of the respiratory
muscles results in diminished breath sounds in the bases.
2. Kyphoscoliosis, a common finding associated with aging, causes the thorax to shorten and the
anteroposterior diameter to increase.
3. As the alveoli become less elastic and more fibrous, dyspnea on exertion becomes more
frequent.
4. Mucous membranes become drier and less able to clear retained mucus
5. Osteoporosis leads to changes in the size and shape of the thorax.
6. trachea and large bronchi become enlarged from calcification of the airways.
7. alveoli enlarge, decreasing the surface area available for gas exchange.
8. number of functional cilia is reduced, causing a decrease in the effectiveness of the cough
mechanism, putting the older adult at increased risk for respiratory infections
9. Changes in the older adult's cough mechanism lead to retention of pulmonary secretions,
airway plugging, and atelectasis if patients do not use cough suppressants with caution.
10. Age-related changes in the immune system lead to a decline of both cell-mediated and
humoral immunity, resulting in an increased risk of respiratory infections
11. Changes in the thorax that occur from ossification of costal cartilage, decreased space
between vertebrae, and diminished respiratory muscle strength lead to problems with chest
expansion and oxygenation
, Subjective data relating to various alterations in the lungs and thorax correct answers 1. Do you
have any chronic illnesses?
a. heart disease or renal disease, which may cause pulmonary edema.
2. Do you have allergies? If so, to what are you allergic? Describe your symptoms. How
frequently do you have these symptoms?
a. can range from mild seasonal allergies to an anaphylactic allergic reaction; runny nose, nasal
congestion, and cough to wheezes and dyspnea. An increased frequency may indicate the onset
of new allergies or ineffective therapy for respiratory disease.
b. Assess history of allergies to pollens, dust, or other airborne irritants and to foods, drugs, or
chemical substances. Symptoms such as choking feeling, bronchospasm with respiratory stridor,
wheezes on auscultation, and dyspnea are often caused by allergic response.
3. Do you have difficulty breathing during your daily activities? If so, describe the difficulty.
a. may have pulmonary or heart disease that limits the availability of oxygen needed during
exertion.
4. Do you have difficulty breathing when you're lying flat? Do you prop yourself up with pillows
to make your breathing easier?
a. Individuals with pulmonary disease may experience an increased work of breathing because of
pressure of the abdominal contents against the diaphragm. They may prop themselves up with
pillows, which moves the abdominal contents away from the diaphragm, to make it easier to
breathe.
5. Are you currently taking any oral medications for a respiratory disorder? If so, which
medications are you taking and how effective are they?
6. Do you use an inhaler? If yes, which medication is in the inhaler, what is the purpose of the
medication, and how often do you use the inhaler?
a. Individuals with asthma or chronic bronchitis may use inhalers to prevent symptoms, treat
bronchial inflammation, or dilate bronchi. How frequently they use their inhalers is an indic
Use assessment skills to obtain objective data relating to various alterations in the lungs and
thorax correct answers i. Routine Assessment Techniques:
1. Perform Hand Hygiene
2. Important Tips for Respiratory Assessment
a. Steth against skin NOT clothing