STUDENT LABORATORY EXERCISES CHAPTER TWELVE: RESPIRATORY SYSTEM Reading Assignment Jones: Patient Assessment in Pharmacy Practice, 2nd ed., Chapter 11, p. 191 Study Questions 1. Define the following: dyspnea, bradypnea, tachypnea, orthopnea, paroxysmal nocturnal dyspnea, wheezing, crackles, rhonchi. 2. Describe how a person’s cough would be characterized with a viral infection; bronchitis; asthma; croup. 3. Describe how a person would appear if he/she were in acute respiratory distress (what signs and symptoms would he/she have?). 4. List and describe 3 types of normal breath sounds. 5. What are adventitious breath sounds? 6. What is O2 saturation? What is the normal range? 7. Describe the significance of a patient having a “barrel chest.” 8. What is the tripod position? When is it used? Audio-Visual Links Patient Assessment in Pharmacy Practice Physical Examination Video: Respiratory System Skills Laboratory This lab session will help you learn the components of assessing the respiratory system. Please remember that if a patient presents with a specific problem/symptom or responds “yes” to any of the general assessment questions regarding the respiratory system, you will need to ask focused questions regarding the specific complaint (please see Box 3-1 in the Health and Medication History laboratory exercise). Learning Objectives o Obtain a person’s history related to pertinent signs and symptoms of the respiratory system. o Inspect, percuss, and palpate the chest. o Auscultate breath sounds and voice sounds. o Demonstrate proper use and interpretation of a peak flow meter. o Document history and physical examination findings, assessment, and potential plan of care. Equipment o Stethoscope; peak flow meter; documentation form. Instructions Wash your hands. Clean the earpieces and endpiece of the stethoscope with an alcohol pad. Pair up with a peer. Practice obtaining subjective information and objective physical examination data regarding a person’s respiratory system. Perform the physical examination of the respiratory system. Obtain the person’s peak expiratory flow rate using a peak flow meter and interpret the results. Document your findings on the assessment form, assess the state of health, and develop a potential plan of care. From Jones, Rospond. Patient Assessment in Pharmacy Practice. 2nd ed. Lippincott Williams & Wilkins, 2009. Form 12-1 RESPIRATORY ASSESSMENT STUDENT NAME Patient Name:____________________________________ Age:_______ Gender:________ Date:_________________ Occupation:_______________________________________ History: Any problems with a cough? No If yes, please describe. Any shortness of breath or problems with your breathing? No If yes, please describe. Any problems with wheezing? No If yes, please describe. Any chest pain or tightness when you breath? No If yes, please describe. Any past history of lung disease? No If yes, please describe. Do you smoke? No If yes, how many per day? How many years have you been smoking? Any living or work conditions that affect your breathing? No If yes, please describe. When was your last TB skin test? When was your last flu shot? When was your last chest x-ray? What medical conditions do you have? What medications do you take? From Jones, Rospond. Patient Assessment in Pharmacy Practice. 2nd ed. Lippincott Williams & Wilkins, 2009. Objective: Vital Signs: Temp:__________________ HR: ____________________ RR: ______________ Resp Pattern:__________________ BP: _______________R arm _______________ L arm Inspection: Facial expression: Skin color: Thoracic cage: Person’s position: Palpation: Symmetrical chest expansion: Tactile fremitus Percussion: Side-to-side comparison: Auscultation of Breath Sounds: Posterior: Adventitious sounds: If abnormal breath sounds are detected, perform bronchophony, egophony, and whispered pectoriloquy. Assessment: Plan: From Jones, Rospond. Patient Assessment in Pharmacy Practice. 2nd ed. Lippincott Williams & Wilkins, 2009.