Assess of Respiratory System

Skill	Document: assessment, interventions, outcomes
Inspect	Respirations for rate, depth, effort, pattern, and presence of cough (productive or nonproductive), noting signs of distress such as nasal flaring or sternal retractions. Inspect size and shape of chest, symmetry of chest wall movement, and use of accessory muscles. Inspect extremities for cyanosis and fingers for clubbing indicating chronic hypoxia. Inspect trachea for scars, stomas, or deviation from midline.
Palpate	Anterior and posterior thorax for subcutaneous emphysema, crepitus, and tenderness. Assess tactile fremitus by palpating the chest as the Pt says “99.”
Percuss	Anterior and posterior thorax for tympany (hollow organs), resonance (air-filled organs), dullness (solid organs), or flatness (muscle or bone).
Auscultate	Use a stethoscope and auscultate all anterior and posterior lung fields, noting normal, abnormal, or absence of lung sounds.