![]() In order to do that, you have to move the patient’s gown - so make sure you’re protecting their dignity and privacy at all times. So starting with the anterior thorax, you’re going to start with inspection. It’s important to note here that you have to assess the lungs and thorax front AND back, so we’ll show you both the anterior assessment and posterior assessment. In this lesson we’re going to look at assessment of the thorax and lungs, so specifically we’re looking at things related to the respiratory system. Same for tactile fremitus – “Say the word “ninety nine” when you feel my hands move.For efficiency-sake – ask the patient to take a deep breath every time they feel your stethoscope on their chest/back.Should have an SpO2 from when you did your vital signs.Request oxygen and chest x-ray from provider if you feel they are necessary.Remember there are nursing interventions you can perform without a provider order to improve respirations:.New or significant findings should be reported to the provider Should see hands expand and return symmetrically.Place hands on lower rib cage with thumbs touching, ask patient to inhale deeply.Decreased vibration = fluid consolidation.Should feel vibrations equally bilaterally.Use the palm of your hands to palpate from the apex down in 5 places as the patient says the word “ninety-nine”.*See Lung Sounds lesson in Respiratory Course for details.Listen to one full respiration in each area.BEST heard with stethoscope directly on skin.Should listen in 10-12 areas on the front.The only way to hear the right middle lobe is to listen near the axilla on the right side.Listen from left to right starting at the apex and moving downward, including the lateral areas.Listen for audible cough, wheezing, or stridor.Starting at the Apex, percuss in the intercostal spaces moving left to right and downward.Using 2 fingers, press lightly on skin over anterior chest, feeling for crepitus – feels like “rice crispies” under skin.Inspect skin color and condition on thorax.Observe the overall rate and rhythm of respirations.Ribs should slope downward from the sternum outward.Expansion should be symmetrical on inspiration.Anterior-Posterior diameter should be approximately ½ the lateral diameter.The thorax and lungs should be assessed anteriorly, posteriorly, and laterally.These cookies are set by embedded Google maps, appear to detect your preferences and recordĪre set by YouTube and/or Google if a video is embedded on a page and/or the video is being played. These cookies are set by Google if the Google+ social plug-in has been activated by the user. On recent searches and previous interactions. These cookies are used by Google to display personalized advertisements on Google sites, baseds This software helps to analyse visitor information such as browser usage, new visitor numbers, response to marketing activity and browsing times. These enable the function of Google Analytics. Poorly-tailored recommendations and slow site performance. ![]() ![]() In some cases these cookies improve the speed with which we can process your request, allow us to remember site preferences you’ve selected. These cookies allow us to improve the site’s functionality by tracking usage on this website.
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