The physical examination includes the assessment of cardiopulmonary system.
· Skin and mucous membrane colour
· General appearance
· Level of consciousness
· Adequacy of systemic circulation
· Breathing patterns
· Chest wall movement
· Observe the rate, depth, rhythm, and quality of respirations, noting the position the client assumes for breathing.
· Variations in the shape of the thorax that may indicate adaptation to chronic respiratory conditions.
· Observe nails for clubbing
· Observe chest wall movement for retraction.
· Observe the patients breathing pattern and assess for paradoxical breathing
· Assess for Kussmaul’s respiration, apnea, Cheyne stokes respiration
· Assess the shape of the chest wall.
· For thoracic excursion, areas of tenderness, tactile fremitus, PMI
· Extremities for peripheral circulation
· Feet and legs determines the presence or absence of peripheral oedema
· Pulses in the neck and extremities to assess arterial blood flow
· It detects the presence of abnormal fluid or air in the lungs
· It helps to identify normal and abnormal heart and lung sounds
The diagnostic tests to assess respiratory status, function and oxygenation includes:
- sputum specimens
- throat cultures
- visualization procedures
- venous and arterial blood specimens
- pulmonary function tests
- X rays
Measurement of arterial blood gases:
Blood for these tests is taken directly from the radial, brachial, femoral arteries or from catheters placed in these arteries.
Pulmonary function tests:
- · Measure lung volume and capacity.
- · The client breathes into a machine (spirometer).
- · The tests are painless, but the client’s cooperation is essential.
- · It requires the ability to follow directions.
- · Nurses need to explain the tests to clients beforehand and help them to rest afterward because the tests are often tiring.