CHRISTIAN CALAMBA BSN 3B September 23, 2021

RLE 112
JOURNAL READING
Assessment of the Respiratory System
Fritz, Deborah PhD, FNP, ANP-BC
SUMMARY
This article, the first in a four-part series, focuses on examination of the
respiratory system.
Subjective Data- A focused assessment of the respiratory system includes a review for
common or concerning symptoms including: Cough-productive/nonproductive, hoarse,
or barking; Sputum characteristics-clear, purulent, bloody (hemoptysis), rust colored, or
pink and frothy; Dyspnea (shortness of breath) with or without activity, wheezing, or
stridor; Chest pain-on inspiration, expiration, or with coughing and location of pain.
Objective Data
Inspection- Visual inspection begins with observation of facial expression, skin color,
moisture, and temperature. Skin should be warm and dry, and skin color should be
uniform and consistent with ethnicity. Facial expression should be relaxed, without
signs of distress or apprehension.
Palpation- Place your index finger in the suprasternal notch at the base of the trachea.
The trachea should be midline and slightly moveable. Pulling of the trachea to either
side of the neck results from unequal intrathoracic pressure within the chest cavity and
may indicate partial to complete pneumothorax, or other serious conditions. Using the
palmar surface of the fingers, palpate the anterior and posterior chest. It should be free
of tenderness, pain, or masses.
Percussion- Percussion is performed by placing the middle finger of the no dominant
hand against the chest wall. The tip of the middle finger on the dominant hand is used to
strike the distal phalanx of the middle finger between the cuticle and the first joint.
Percussion is helpful to determine the density of the underlying lung tissue and identify
the position of the diaphragm during inspiration and expiration.
Auscultation- Ask the patient to breathe slowly and deeply through their open mouth.
Using the diaphragm of your stethoscope, listen in the ladder pattern posterior (Figure
1) and anterior (Figure 2), noting the breath sounds (Table 2). Listen in each area for at
least one full breath. In the person unable to sit up without help—percuss the upper lung
and auscultate the dependent lung on each side.
REFLECTION:
Assessment is the most vital phase in the nursing process, it is the ground in
making the nursing interventions for the patients. This journal give me hint on the
correct procedure that we are going to follow for us to be able to know the clients
condition in respiration. The journal tackled on the phases or parts in examining a
client’s respiratory system.

Along my journey reading the journal I was able to know more about the IPPA
technique which used in this assessment. The inspection which will give us hint on the
conditions observed by our eyes, the palpation which enable us to know tenderness,
pain or masses that is present to the client. The third one is the percussion which give us
hint on determining the density of the underlying lung tissue, and the auscultation in
which we are able to listen to the breath and lung sounds.

Overall, the journal was a great refreshment on the technique on assessing the
respiratory system, it add inputs to what we have learned on the past academic journey.
In this way, we can have our improvements in giving quality care to our clients in the
near future. Throughout this, I may have the confidence on my ideas most especially we
are dealing lives of people.