RETURN DEMONSTRATION EVALUATION TOOL FOR:

Assessing the Thorax and Lungs

Name: _____________________________________ Grade: _____________
Time started:____________ Time ended:____________ Date of RD:________________________

AREA FOR EVALUATION RATING COMMENTS

SKILLS (35%) 5 4 3 2 1 0
ASSESSMENT /PLANNING
1. Check doctor’s order.
2. Assemble equipments:
 Stethoscope
 Skin marker/pencil
 Centimeter ruler
IMPLEMENTATION
3. Identifies client.
4. Explains to the client what you are
going to do, why it is necessary,
and how he or she can cooperate.
5. Washes hands and observes
other appropriate infection control
procedures.
6. Provides for client’s privacy.
7. Determines client’s history of the
following:
 Family history of illness, including
cancer
 Allergies
 Tuberculosis
 Smoking and occupational
hazards
 Any medications being taken
 Current problems such as
swellings, coughs, wheezing,pain
Posterior Thorax
8. Inspects the shape and symmetry
of the thorax from posterior and
lateral views..
9. Inspects the spinal alignment for
deformities.
a. Have the client stand. From a
lateral position, observe the three
normal curvatures: cervical,
thoracic, and lumbar.
b. To assess for lateral deviation of
spine (scoliosis), observe the
standing client from the rear.
Have the client bend forward at
the waist and observe from
behind.
 10. Palpates the posterior thorax.

11. Palpates the posterior chest for

respiratory excursion.
12. Palpates the chest for vocal
(tactile) fremitus.
13. Percusses the thorax.

14. Percuss for diaphragmatic

excursion.
15. Ausculatates the chest using the
flat-disc diaphragm of the
stethoscope.
Anterior Thorax
16. Inspects breathing patterns.
17. Inspects the costal angle and the
angle at which the ribs enter the
spine.
18. Palpates the anterior chest.
19. Palpates the anterior chest for
respiratory excursion.
20. Palpates the tactile fremitus in the
same manner as for the posterior
chest.
21. Percusses the anterior chest
systematically.
22. Auscultates the trachea.
23. Auscultates the anterior chest.
EVALUATION/DOCUMENTATION
1. Documents findings in the client’s
record.
KNOWLEDGE: (15%)
1. Gives rationale of the procedure.
2. Explains the elements and
mechanics of the procedure.
3. Knows the elements of nursing
process as applied.
4. States principles applied in the
procedure.
ATTITUDE: (10%)
1. Is well groomed.
2. Wears prescribed, neat, and clean
uniform.
3. Arrives on time for the RD.
4. Speaks to CI and client tactfully.
5. Minimizes use of energy, time, and
effort
6. Utilizes supplies efficiently.
7. Considers client’s safety, privacy, and
comfort.
8. Is well organized.
9. Keeps working area clean at all times.
10. Gives high value for aesthetics.

Comments: _______________________________________________________________
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Clinical Instructor’s signature: ____________________________________