Respiratory documentation: Subjective data: Cough. Shortness of breath. Chest pain with breathing.

reathing. History of respiratory infections, Allergies asthma, COPD, pneumonia, TB. Dyspnea. Smoking habits. Activity restrictions. Environmental exposure to toxins. Self-care behaviors -last TB skin test, chest x ray, influenza vaccination.

Objective data: i Inspection. Position of the trachea mid line without deviation. Thoracic configuration A-P/T diameter equal . Chest movement each side have equal upward and downward movement with inspiration and expiration (symmetric expansion). Effort less sound less respiration with a regular rate, rhythm and depth, nose breathing. Neck muscle and trapezius muscles not appear during respiration. Mass or lesion: none. Relaxed posture of the person's position during respiration. Skin color and condition are unified consistent color. No audible adventitious breathing sounds. Spinal curvature- scapula and shoulder are in same line.

ii- Palpation : Sternum, costal cartilage, ribs, ICS and spine with no tenderness. Muscles are firm, smooth and symmetrical No plugging or retraction of muscles or ribs. No palpable skin masses No crepitus or crepitation over the subcutaneous tissues. The thumbs move a part symmetrically in chest expiation. Tactile fremitus: Resonant phrase generates strong vibrations between scapula closer to the bronchial bifurcation feel strong vibrations on the right chest than the left and also in thin chest. Decrease vibration as you go down. Decreased or absent over the pericardium anteriorly. iii- Percussion: Resonance- in healthy lung tissue. Diaphragmatic excursion "equal bilaterally & measure 3-5 cm in adults".

IV- Auscultation: BRONCHIAL- High-pitched, harsh, tubular; inspiration< expiration; Heard over trachea. Bronchovesicular- Moderate, mixed quality; inspiration=expiration; Heard over major bronchi. Vesicular- Low, soft rustling; inspiration > expiration; Heard over peripheral lung fields.