Assesment of patients with Respiratory system diordes.pptx

History and physical examination of patient with respiratory disorders

1. ASSESMENT OF RESPIRATORY SYSTEM

2. Objectives At the end of the session learner will be able to; Describe how to assess respiratory system 6-May-24 2 Prep by A.A

3. Anatomic and Physiologic Overview Upper Respiratory Tract Consists o f the: Nose Sinuses And Nasal Passages Pharynx Tonsils And Adenoids Larynx, And Trachea. 6-May-24 3 Prep by A.A

4. Lower Respiratory Tract consists of the : Lungs Bronchial Alveolar 6-May-24 4 Anatomic and Physiologic Overview…. Prep by A.A

5. 6-May-24 5 Prep by A.A

6. Function of the Respiratory System Oxygen transport Respiration (gas exchange between atmospheric air and the blood and between the blood and cells of the body) Ventilation ( movement of air in and out of airways) Gas exchange 6-May-24 6 Prep by A.A

7. Assessment of patient with respiratory disorder Health History major signs and symptoms of respiratory disease are Dyspnea Cough Sputum Production Chest Pain Wheezing Hemoptysis. 6-May-24 7 Prep by A.A

8. Assessment….. Past Health, Family, and Social History The midwife obtains a brief history of events and conditions. Ask about childhood illnesses, immunizations, chronic medical conditions, injuries , hospitalizations, surgeries, allergies, and current medications (including over-the-counter medications and herbal remedies). 6-May-24 8 Prep by A.A

9. Physical Assessment General Appearance Inspect for clubbing of the fingers Cyanosis (bluish skin color) Nose and Sinuses, Mouth and Pharynx, Trachea Assessment….. 6-May-24 9 Prep by A.A

10. Assessment of the lower respiratory structures includes Inspection Palpation Percussion Auscultation of the thorax. 6-May-24 10 Assessment….. Prep by A.A

11. Thoracic Inspection Chest Configuration. Barrel chest Funnel chest ( pectus excavatum ), Pigeon chest ( pectus carinatum ), and Kyphoscoliosis . Breathing Patterns and Respiratory Rates. 6-May-24 11 Assessment….. Prep by A.A

12. Pectus carnitum (pigeon chest ) Pectus Excavatum (Funnel ) 6-May-24 12 Assessment….. Prep by A.A

13. Barrel Chest 6-May-24 13 Assessment….. Prep by A.A

14. Compare abnormality vs normality 6-May-24 14 Prep by A.A

15. Thoracic Palpation Thorax is palpated for: Tenderness, masses, lesions Respiratory excursion Vocal fremitus Tracheal location 6-May-24 15 Assessment….. Prep by A.A

16. Assessment….. 6-May-24 16 Respiratory excursion- estimation of the thoracic expansion Place both hands posterior at the level of T9 or T10. Slide hands medially to pinch a small amount of skin between your thumbs. Observe for symmetry as the patient exhales fully following a deep inspiration. Normally symmetric Asymmetric due to pleurisy, fracture ribs or trauma to the chest call or unilateral bronchial obstruction . Prep by A.A

17. 6-May-24 17 Tactile fremitus Capacity to feel sound (vibration) on the chest wall. Have client say “ ninety-nine” or “44 ” Compare the transmission of sound on both sides of the chest for symmetry by using palmar surface of the fingers and hands Assessment….. Prep by A.A

18. Thoracic Percussion to determine whether underlying tissues are filled with air, fluid, or solid material . 6-May-24 18 Assessment ….. Prep by A.A

19. 6-May-24 19 Assessment ….. Prep by A.A

20. Thoracic Auscultation is useful in assessing the flow of air through the bronchial tree and in evaluating the presence of fluid or solid obstruction in the lung. auscultate for; Normal breath sounds Adventitious sounds Voice sounds. 6-May-24 20 Assessment ….. Prep by A.A

21. Breath Sounds. Normal breath sounds are distinguished by their location over a specific area of the lung and are identified as Vesicular Bronchovesicular bronchial (tubula r ) breath sounds 6-May-24 21 Assessment….. Prep by A.A

22. 6-May-24 22 Assessment….. Prep by A.A

23. Adventitious Sounds. An abnormal condition that affects the bronchial tree and alveoli may produce adventitious sounds A re divided into two categories: Crackles ( discrete, noncontinuous sounds ) and Wheezes s (continuous musical sound) 6-May-24 23 Assessment….. Prep by A.A

24. Voice Sounds. Bronchophony and egophony Are usually assessed by having the patient repeat “ ninety-nine” or “ eee ” while you listen with the stethoscope in corresponding areas of the chest from the apices to the bases. Are indicative of consolidation, such as occurs in pneumonia, or pleural effusion. 6-May-24 24 Assessment….. Prep by A.A

25. 6-May-24 25 Bronchophony describes vocal resonance that is more intense and clearer than normal . Egophony describes voice sounds that are distorted. It is best appreciated by having the patient repeat the letter E . The distortion produced by consolidation transforms the sound into a clearly heard A rather than E. Assessment….. Prep by A.A

26. Diagnostic Evaluation Arterial Blood Gas Studies- blood pH, PaO2, PaCO2 Pulse Oximetry is a noninvasive method of continuously monitoring the oxygen saturation of hemoglobin (SaO2). Cultures- to identify organisms for pharyngitis . Sputum Studies 6-May-24 26 Assessment ….. Prep by A.A

27. pulse oximetry 6-May-24 27 Assessment….. Prep by A.A

28. Imaging Studies Imaging studies, including x-rays Computed tomography(CT) Magnetic resonance imaging (MRI) Contrast studies, and radioisotope diagnostic scans 6-May-24 28 Assessment….. Prep by A.A

29. Endoscopic Procedures include; Bronchoscopy Thoracoscopy Thoracentesis Biopsy 6-May-24 29 Assessment….. Endoscopic thoracoscopy thoracentesis Prep by A.A

30. 6-May-24 30 Thank you Prep by A.A