Name: respiratory assessment signs and findings
Uploaded: 2024-06-20T13:03:00.000Z
Duration: 1 min 23 s
Channel: JoVE

Begin the assessment by explaining the purpose of the assessment and obtaining informed consent.
The respiratory assessment involves assessing the anterior, posterior, and lateral thorax. First, observe for signs of respiratory distress or difficulty breathing.
Perform hand hygiene to avoid cross-infection. Provide a comfortable position to the patient.
Ask the patient about any history of respiratory problems, including asthma, chronic bronchitis, or emphysema.
Start the assessment by inspecting the patient&#39;s chest for symmetry in shape and movement with respiration.
Assess for cyanosis around the lips or nail beds, which may suggest low oxygen levels in the bloodstream.&#160;
Next, palpate the chest wall for tenderness or abnormal expansion.
Then, percuss the chest to detect areas of dullness or hyperresonance, which could indicate a consolidation or pleural effusion.
Lastly, auscultate lungs with a stethoscope for abnormal breath sounds such as rhonchi, wheezes, or crackles, which may suggest airway obstruction or infection.
Replace the equipment and perform hand hygiene.
Document findings in the medical record.

assessment of respiration

Assessment of Respiration

The respiratory system&#39;s basic structures and primary functions lay the foundation for nurses&#39; comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient&#39;s respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual&#39;s medical history, medications, and symptoms, focusing on past respiratory conditions like asthma or COPD, surgeries, and allergies. It is important to ask about the family history to identify genetic predispositions and shared environmental factors.
Nurses should inquire about respiratory symptoms, including the presence, frequency, severity of coughs, and factors that worsen or alleviate them. Information on sputum color, consistency, and amount provides insights into potential respiratory conditions.
Lifestyle and environmental factors impacting respiratory health are also part of the subjective data. It includes smoking history, exposure to secondhand smoke, occupational exposure to irritants or toxins, and living conditions like mold, dust, and pet dander.
Objective Assessment: The objective assessment involves checking vital signs and physically examining the patient through inspection, palpation, auscultation, and percussion.
Evaluate Vital Signs: The assessment begins with interpreting vital signs, specifically the respiratory rate and pulse oximetry readings. Adults typically have a respiratory rate of 12-20 breaths per minute at rest, with ideal blood oxygen saturation levels between 95&#8211;100% (SpO2).
Inspection: A thorough inspection is critical, focusing on the patient&#39;s consciousness level, breathing rate, pattern, effort, skin color, chest configuration, and symmetry of expansion. Observations include breathing patterns and signs of respiratory difficulty like pursed-lip breathing, nasal flaring, and intercostal retractions. The chest is inspected for symmetry and configuration, focusing on the anteroposterior-transverse ratio, ideally 1:2.
Palpation: Palpation helps investigate abnormalities related to injury or procedural complications. Symmetric chest expansion is confirmed by placing hands on the chest at the same level, noting any unequal expansion that may indicate conditions like pneumonia or pneumothorax.
Auscultation: Auscultation involves listening to air movement during inspiration and expiration, typically using a stethoscope. Expected breath sounds include bronchial sounds over the trachea, bronchovesicular sounds over major bronchi, and vesicular breath sounds over lung surfaces. Adventitious lung sounds like wheezing, crackles, rales, rhonchi, stridor, and pleural rub are also noted.
Percussion: Percussion involves striking the fingers over lung fields to differentiate sounds. Dull sounds indicate high-density areas like pneumonia or atelectasis, while clear, low-pitched, hollow sounds are typical of normal lung tissue.
In summary, a focused respiratory assessment, including a thorough examination, is vital for identifying potential issues, monitoring changes, and facilitating timely interventions.

The respiratory system&#39;s basic structures and primary functions lay the foundation for nurses&#39; comprehensive respiratory assessments. This ...

Education

JoVE Core

Nursing

Unit 1

Vital Signs: Respiration

KEY TERMS AND CONCEPTS

respiratory assessment signs and findings

Respiratory assessment looks at the signs and findings that show how well a person is breathing. It uses both subjective data and objective data to judge respiratory health. The respiratory system’s basic structures and main functions provide the basis for this check.

Subjective assessment starts with an interview. Nurses ask about medical history, medicines, current symptoms, past respiratory problems like asthma or COPD, surgeries, and allergies. Family history also matters because it can point to genetic risk and shared environmental factors.

The interview also focuses on cough and sputum. Nurses note whether a cough is present, how often it happens, how severe it is, and what makes it worse or better. They also ask about sputum color, consistency, and amount because these details can suggest a respiratory problem.

Lifestyle and environment are part of the history too. Smoking, secondhand smoke, work exposure to irritants or toxins, and home conditions such as mold, dust, and pet dander can all affect breathing health. These details help explain why symptoms may develop or worsen.

Objective assessment uses vital signs and a physical exam. The first checks are respiratory rate and pulse oximetry, which measures blood oxygen saturation. At rest, adults typically breathe 12 to 20 times per minute, and ideal SpO2 levels are 95–100%.

Inspection comes next. The nurse looks at the person’s level of consciousness, breathing rate, breathing pattern, effort, skin color, chest shape, and how evenly the chest expands. Signs of distress can include pursed-lip breathing, nasal flaring, and intercostal retractions. The chest is also checked for symmetry and for the normal anteroposterior-transverse ratio of about 1:2.

Palpation helps find problems linked to injury or procedure complications. The nurse places both hands on the chest at the same level to compare expansion on each side. Unequal expansion can suggest conditions such as pneumonia or pneumothorax.

Auscultation means listening to air movement with a stethoscope during inhalation and exhalation. Normal breath sounds include bronchial sounds over the trachea, bronchovesicular sounds over the major bronchi, and vesicular sounds over the lung surfaces. The nurse also listens for wheezing, crackles, rales, rhonchi, stridor, and pleural rub.

Percussion adds more detail by using finger strikes over the lung fields. Clear, low-pitched, hollow sounds usually match normal lung tissue. Dull sounds can point to high-density areas such as pneumonia or atelectasis. A focused respiratory assessment helps identify problems, track changes, and support timely care.

Respiratory Assessment Signs and Findings

respiratory-assessment-signs-and-findings

respiration

Respiratory System and Gas Exchange

The respiratory system supports energy production by bringing oxygen into the body and removing carbon dioxide. In human cells, oxidation uses food molecules and oxygen to produce carbon dioxide and water. This process helps sustain life and depends on the respiratory system. Air moves through a pathway that includes the nose, oropharynx, larynx, trachea, bronchi, bronchioles, and lungs. Air enters through the nose and mouth, passes through the pharynx, and then moves through the larynx, which...

physiological control of respiration

How the Brain Regulates Breathing

How the brain regulates breathing is controlled by the respiratory center in the brainstem. This center manages involuntary breathing, so respirations continue without conscious effort and stay smooth and steady. Ventilation is maintained by monitoring carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration, or pH, in arterial blood. CO2 is the most important signal in this control system. When CO2 rises, the respiratory control system increases the rate and depth of breathing so...

respiration and gaseous exchange

How Heart and Lungs Exchange Gases

Heart and lung function work together to move oxygen and carbon dioxide through the body. This gas exchange depends on the cardiovascular system, which includes the heart and blood vessels, and on the respiratory system, which brings air to the alveoli and removes waste gases. The heart is a cone-shaped muscular pump at the center of this system. It has four chambers: two atria on top and two ventricles below. The atria receive blood from veins, including the superior and inferior vena cava...

mechanism of breathing i: inspiration

How Air Moves Into the Lungs

Air enters the lungs through a coordinated breathing process called inspiration, or inhalation. This is the first phase of the respiratory cycle. The respiratory system includes the conducting zone and the respiratory zone, and both help move air toward the place where gas exchange occurs. During inspiration, air comes in through the nose or mouth and passes through the conducting zone. This pathway includes the nasal cavity, trachea, and bronchi. These structures filter, warm, and humidify...

mechanism of breathing ii: expiration

How the Body Pushes Air Out

Expiration is the process of pushing air out of the lungs. It begins when the inspiratory muscles relax. That relaxation starts a chain of changes in the chest and lungs. As the diaphragm relaxes, it moves upward. This lowers the volume of the thoracic cavity, or chest space. The pleural cavity also contracts and presses on the lungs. The intercostal muscles, which sit between the ribs, help during this phase too. They pull the ribs downward and inward. This makes the chest cavity even...

mechanism of breathing iii: the accessory muscles

mechanism-of-breathing-iii-the-accessory-muscles

Accessory Muscles That Support Breathing

Accessory muscles help the respiratory system expand the chest and move air when breathing needs extra effort. The diaphragm is still the main breathing muscle, but other muscles can assist during inhalation and exhalation. This support becomes important during deep breathing or when the body faces breathing challenges. Several accessory muscles help with inhalation. The sternocleidomastoid, which is in the neck, lifts the sternum and helps the chest cavity expand. The scalene muscles also sit...

factors affecting respiration

How Breathing Changes in Different Conditions

Respiration changes with age, activity, health, and the environment. It is the process of exchanging oxygen (O2) and carbon dioxide (CO2) between the body and the surroundings. Many factors can alter how fast and how deeply a person breathes. Newborns usually breathe faster than older children and adults. Their respiratory rate can range from thirty to sixty breaths per minute because their metabolic needs are higher. As people age, metabolic rate often decreases, and breathing tends to slow. <br...

respiratory assessment: purpose and indications

respiratory-assessment-purpose-and-indications

Breathing Checks in Patient Monitoring

Respiratory assessment is a key part of patient monitoring in nursing. It helps detect early signs of clinical deterioration. Breathing changes often appear before other signs of worsening health, so nurses watch respiratory rate, breathing pattern, and breath sounds closely. A complete respiratory assessment goes beyond counting breaths. It includes inspection, which means looking at chest symmetry, effort, and use of accessory muscles. It also includes palpation, or feeling for tenderness,...

assessment of airway, skin color, and use of accessory muscles

assessment-of-airway-skin-color-and-use-of-accessory-muscles

Respiratory Signs to Check During Breathing

Respiratory assessment starts with checking the airway, skin color, and use of accessory muscles during breathing. These signs give quick clues about respiratory status and possible complications. A clear airway, normal skin color, and no accessory muscle use usually point to effective oxygenation and perfusion. Airway assessment is an important first step in any health check. Clinicians look for anything that could block breathing, such as vomit, a foreign object, or the tongue. In a...

assessment of ventilation i: respiratory rate

assessment-of-ventilation-i-respiratory-rate

Checking Breathing Patterns and Respiratory Rate

Ventilation assessment helps monitor a patient’s health status by checking breathing patterns and respiratory rate. Respiration is one of the easiest vital signs to observe. It can also show problems in several body systems, including serious issues such as brainstem injury after head trauma. Accurate assessment depends on unobtrusive observation. The patient should not know they are being watched, because awareness can change breathing patterns. A full evaluation also considers the patient’s...

assessment of ventilation ii: respiratory depth and rhythm

assessment-of-ventilation-ii-respiratory-depth-and-rhythm

Watching Breathing Depth and Rhythm

Breathing depth and rhythm help show how a person is ventilating. Respiratory depth is the amount of air inhaled or exhaled in one breath. It may be shallow or deep, and it usually stays steady when a person is resting or asleep. A deep sigh is an automatic deep breath that fills the lungs with more air than normal breathing. Respiratory depth is checked by watching chest excursion, or chest movement. Deep respiration shows full lung expansion and complete exhalation. Shallow respiration moves...

assessment of diffusion and perfusion

Gas Exchange Checks in Respiratory Care

Gas exchange checks in respiratory care focus on diffusion, perfusion, oxygen saturation, and capnography. These measures help show how well the lungs and blood vessels move oxygen in and remove carbon dioxide from the body. Diffusion is the movement of molecules from an area of higher concentration to an area of lower concentration. In the lungs, oxygen diffuses from the alveoli, the tiny air sacs, into the bloodstream. Carbon dioxide, which is made during cell metabolism, moves from the...

respiratory volumes and capacities i

Breathing Rates and Pattern Changes

Breathing rate and rhythm are important signs of respiratory health. A complete one-minute count helps show the patient’s breathing pattern. Even a small rise of three to five breaths per minute can be an early sign of respiratory distress. Patients with a rate above twenty-four breaths per minute need close monitoring for possible changes in body function. Normal and abnormal respirations have clear names. Eupnea means normal, gentle breathing with a regular rate and rhythm, usually twelve to...

alterations in respiration ii

Breathing Patterns and Their Clinical Meaning

Breathing patterns can be regular, deep, or shallow, and they can also become abnormal. These changes help explain how ventilation is affected in different conditions. Clinically, they are important because they can guide patient evaluation. Biot's breathing is irregular in both rate and depth. It alternates between deep gasping breaths and apnea, which is a pause in breathing. It may occur with increased intracranial pressure or damage to the brain's respiratory center, such as from stroke,...

respiratory volumes

Measuring Lung Air Volumes

Respiratory volumes measure how much air moves in and out of the lungs during breathing. These values help assess lung function, support diagnosis of respiratory conditions, and track overall respiratory health. Each measurement gives a different view of how the lungs work. Tidal volume (TV) is the air inhaled or exhaled in one normal breath. In adults, it is about 500 milliliters per breath. It serves as the baseline volume for resting breathing. Minute volume (MV) is the total air exchanged...

respiratory capacities

Lung Capacity Measures in Breathing

Lung capacity measures show how much air the respiratory system can move and hold during different parts of breathing. These measures help describe lung function in a more complete way. They are useful for understanding how the lungs work during inhaling and exhaling. Inspiratory capacity, or IC, is the maximum amount of air that can be inhaled with full effort. It is found by adding tidal volume and inspiratory reserve volume. IC usually ranges from 2.4 to 3.6 liters. Functional residual...

special considerations while measuring oxygen saturation

special-considerations-while-measuring-oxygen-saturation

Checking Breathing Rate and Oxygen Levels

Checking breathing rate and oxygen levels helps assess how well a patient is breathing. Respiratory rate is the number of breaths taken in one minute. Oxygen saturation shows how much oxygen is being delivered to the body’s tissues. Together, these signs give a fuller picture of respiratory function. The normal adult breathing rate is usually 12 to 20 breaths per minute. A lower rate may suggest respiratory depression or decreased oxygen levels. A rate above 20 breaths per minute may point to...

Respiratory assessment looks at the signs and findings that show how well a person is breathing. It uses both subjective data and objective data to judge respiratory health. The respiratory system’s basic structures and main functions provide the basis for this check. Subjective assessment starts with an interview. Nurses ask about medical history, medicines, current symptoms, past respiratory problems like asthma or COPD, surgeries, and allergies. Family history also matters because it can...

key terms and concepts

Learn how respiratory assessment uses history, vital signs, inspection, palpation, auscultation, and percussion to spot breathing problems and lung sounds.

Respiratory Assessment Signs and Findings | JoVE K12

JoVE Core Nursing offers concise animated lessons on nursing practices, covering health systems, nursing organizations, and health concepts. It includes practical communication, infection prevention, and nursing fundamentals, providing students with a clear understanding of nursing principles.

nursing

Respiratory Assessment Signs and Findings

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