THE COLLEGE OF MAASIN

Nisi Dominus Frustra

College of Nursing and Allied Health Sciences
Maasin City, Southern Leyte

PERFORMANCE CHECKLIST
Health Assessment
Thoracic and Lung Assessment

Name:____________________________________ Grade:__________
Year and Section:__________________________ Date:____________

Legend: S – Satisfactory US – Unsatisfactory

PROCEDURE S US
1. Prepare the patient and environment.
2. Introduce self to client and explains the procedure .
3. Ask client’s health history and data on relevant assessment
4. Position the client appropriately and asks the client to undress and drape.
5. Do hand hygiene.
Inspection
6 Inspect for nasal flaring and pursed lip breathing
7. Observe color of face and chest
8. Observe quality and pattern of respiration
Posterior/Anterior Thorax
9. Inspect Configuration
10. Inspect intercostal space
11.Observe use of accessory muscles
Palpation
12.Palpate for tenderness, sensation and crepitus
13.Palpate for tactile fremitus
14. Assess chest expansion
Percussion
15.Percuss the tone
16. Percuss for diaphragmatic excursion
Auscultation
Auscultate for breath sounds
17a. Identify normal breath sounds
17b. Identify adventitious breath sounds
18. Documents all procedure and observations done.
19. Visualize landmarks and recall the imaginary landmarks /lines of the anterior, posterior and
lateral areas.
20. . Maintains body mechanics throughout the performance of procedure.
21. Manifests neatness in the performed procedure.
22 receptive to criticisms.
23. observes courtesy.
24. Shows calmness while performing the procedure.
25. Uses correct English.
26. Shows mastery of the procedure.
27. Give appropriate answers to questions.
29. States rationale for each action.
29. Maintains good personal appearance during the performance of the procedure.
Remarks:

Recommendation: Pass___ needs more practice____

Student:________________________ Date:___________

Instructor:______________________ Date:___________