NR 302 FINAL EXAM STUDY GUIDE
I I I I I
Thorax and Lungs
I I
-What Idata Ican Ibe Igathered Ion Ia Ipatient Iin Irespiratory Idistress Ifrom Igeneral Isurvey Ionly?
-Do Ithey Iuse Iaccessory Imuscles Iwhen Ibreathing? IPosition-tripod, IBarrel Ichest, INasal Iflaring,
Icolor
-Structure Iand IFunction: IThe Ithorax
-Thoracic Icage
-Sternum, I12 Ipairs Iof Iribs
-12 Ithoracic Ivertebrae
-Muscles Iand Icartilage
-Thoracic ICavity
-Mediastinium
-Pleural Icavity
-Lung I(Apex Iand Ibase)
Structure and Function: Pleural Membranes
I I I I
-Parietal Ipleura-lines Ithe Iwhole Icavity
-Visceral Ipleura-lines Ithe Iorgans
-Pleural Ispace/cavity-both Iabove Itotal
Structure and Function: The respiratory system
I I I I I
-Trachea
-Bronchi
-Bronchioles
-Alveolar ISacs
-Alveoli
Landmarks-Visualize what you cannot see!
I I I I
-Anterior Ichest
-Suprasternal Inotch I“U Ishaped”
-Sternum
-Sternal Iangle I(Angle Iof ILouis) Icontinuous Iwith I2nd Irib
-Ribs I& Iintercostals
-Costal Iangle I(at Ixiphoid) I90 Idegrees
-Posterior Ichest
-Vertebra Iprominence IC7
-Spinous Iprocesses IT1 Iis I1st Irib
-T3 Iseparates Iupper Iand Ilower Ilobes
-Inferior Iborder Iof Ithe Iscapula I8th Irib
-12th Irib
Subjective Data I
, -Difficulty Ibreathing, Isleeping, Ichest Ipain, Icough Iand Isputum I(Rusty-TB), Ismoking Ihistory,
Ienvironmental Iexposure
TO Icalculate Ismoking Ipack-years
1. Multiple Ithe Inumber Iof Icigarettes Ismoked Iper Iday Iby Inumber Iof Iyears Ismoked
2. Divide Iby I20
i.e I10 Icigarettes Ismoked Iper Iday Ix I10 Iyears I/ I20 I= I5 Ipack Iyears
Objective Data I
-Inspection Iof Ipatient: IResp. Irate I& Ieffort Ito Ibreathe I(Nasal Iflaring, Iaccessory Imuscles,Ipositioning)
Iskin Icolor, Inails, Iconfiguration Iof Ichest I(Chest Ideformities)
-Palpation Iof Ianterior Iand Iposterior Ichest: ITenderness, Ilumps, Icrepitus I(Subcutaneous Iair-rice
Ikrispis Iunder Iskin), Itactile Ifremitus I(99), Irespiratory Iexpansion
-Percussion Iof Ilung Ifields: IResonance, Ihyper-resonance, Idull, Idiaphragmatic Iexcursion
-Auscultation Iof Ichest: INormal, Iadventitious, Ivoice Isounds, Imeasurements Iof Ipulmonary
Ifunction: IFor Iscreening**Begin Iat Ithe Imoment Iof Icontact
Normal breath sounds
I I
-Bronchial I(Tracheal) I–Over Itrachea I& Ilarynx IE>1
-Bronchovesicular—Over Imajor Ibronchi II=E
-Vesicular—over Iperipheral Ilung Ifields II>E
Normal Assessment Findings
I I
-Inspection: IRR I14 Ireg,even I& Iunlabored I(eupnea), Iskin I& Inails Ipink, Ino Icyanosis Inoted, Irelaxed
Iposture, Ishape Isymmetric IAP: ITransverse I1:2, Icostal Iangle I<90 Idegrees
-Palpation: IChest Iexpansion Isymmetric, Itactile Ifremitus Isymmetric, Ino Itenderness, Ino Icrepitus,
Ino Ilumps Ior Imasses
-Percussion: IResonance Ithroughout, Idiaphragmatic Iexcursion Iequal Ibilaterally
-Auscultation: INormal Ibreath Isounds
Adventitious Breath sounds
I I
-Crackles/rales
-Pleural Ifriction Irub
-wheeze
-Rhonchi
Voice Sounds
I
-Bronchophony I“99”
-Egophony I“EEEEEE”
-Whispered IPectoriloquy I“one-two-three”
Abnormal breathing patterns
I I
-Tachypnea
-Bradypnea
-Hyperventilation
-Hypoventilation
I I I I I
Thorax and Lungs
I I
-What Idata Ican Ibe Igathered Ion Ia Ipatient Iin Irespiratory Idistress Ifrom Igeneral Isurvey Ionly?
-Do Ithey Iuse Iaccessory Imuscles Iwhen Ibreathing? IPosition-tripod, IBarrel Ichest, INasal Iflaring,
Icolor
-Structure Iand IFunction: IThe Ithorax
-Thoracic Icage
-Sternum, I12 Ipairs Iof Iribs
-12 Ithoracic Ivertebrae
-Muscles Iand Icartilage
-Thoracic ICavity
-Mediastinium
-Pleural Icavity
-Lung I(Apex Iand Ibase)
Structure and Function: Pleural Membranes
I I I I
-Parietal Ipleura-lines Ithe Iwhole Icavity
-Visceral Ipleura-lines Ithe Iorgans
-Pleural Ispace/cavity-both Iabove Itotal
Structure and Function: The respiratory system
I I I I I
-Trachea
-Bronchi
-Bronchioles
-Alveolar ISacs
-Alveoli
Landmarks-Visualize what you cannot see!
I I I I
-Anterior Ichest
-Suprasternal Inotch I“U Ishaped”
-Sternum
-Sternal Iangle I(Angle Iof ILouis) Icontinuous Iwith I2nd Irib
-Ribs I& Iintercostals
-Costal Iangle I(at Ixiphoid) I90 Idegrees
-Posterior Ichest
-Vertebra Iprominence IC7
-Spinous Iprocesses IT1 Iis I1st Irib
-T3 Iseparates Iupper Iand Ilower Ilobes
-Inferior Iborder Iof Ithe Iscapula I8th Irib
-12th Irib
Subjective Data I
, -Difficulty Ibreathing, Isleeping, Ichest Ipain, Icough Iand Isputum I(Rusty-TB), Ismoking Ihistory,
Ienvironmental Iexposure
TO Icalculate Ismoking Ipack-years
1. Multiple Ithe Inumber Iof Icigarettes Ismoked Iper Iday Iby Inumber Iof Iyears Ismoked
2. Divide Iby I20
i.e I10 Icigarettes Ismoked Iper Iday Ix I10 Iyears I/ I20 I= I5 Ipack Iyears
Objective Data I
-Inspection Iof Ipatient: IResp. Irate I& Ieffort Ito Ibreathe I(Nasal Iflaring, Iaccessory Imuscles,Ipositioning)
Iskin Icolor, Inails, Iconfiguration Iof Ichest I(Chest Ideformities)
-Palpation Iof Ianterior Iand Iposterior Ichest: ITenderness, Ilumps, Icrepitus I(Subcutaneous Iair-rice
Ikrispis Iunder Iskin), Itactile Ifremitus I(99), Irespiratory Iexpansion
-Percussion Iof Ilung Ifields: IResonance, Ihyper-resonance, Idull, Idiaphragmatic Iexcursion
-Auscultation Iof Ichest: INormal, Iadventitious, Ivoice Isounds, Imeasurements Iof Ipulmonary
Ifunction: IFor Iscreening**Begin Iat Ithe Imoment Iof Icontact
Normal breath sounds
I I
-Bronchial I(Tracheal) I–Over Itrachea I& Ilarynx IE>1
-Bronchovesicular—Over Imajor Ibronchi II=E
-Vesicular—over Iperipheral Ilung Ifields II>E
Normal Assessment Findings
I I
-Inspection: IRR I14 Ireg,even I& Iunlabored I(eupnea), Iskin I& Inails Ipink, Ino Icyanosis Inoted, Irelaxed
Iposture, Ishape Isymmetric IAP: ITransverse I1:2, Icostal Iangle I<90 Idegrees
-Palpation: IChest Iexpansion Isymmetric, Itactile Ifremitus Isymmetric, Ino Itenderness, Ino Icrepitus,
Ino Ilumps Ior Imasses
-Percussion: IResonance Ithroughout, Idiaphragmatic Iexcursion Iequal Ibilaterally
-Auscultation: INormal Ibreath Isounds
Adventitious Breath sounds
I I
-Crackles/rales
-Pleural Ifriction Irub
-wheeze
-Rhonchi
Voice Sounds
I
-Bronchophony I“99”
-Egophony I“EEEEEE”
-Whispered IPectoriloquy I“one-two-three”
Abnormal breathing patterns
I I
-Tachypnea
-Bradypnea
-Hyperventilation
-Hypoventilation
