General overlook for respiratory case examination Respiratory patients may be short of breath, and it may be easiest to examine them sitting at the edge of the bed instead of in the classic position of sitting back at 45 * . Choose a position comfortable to you both. The patient should be undressed to the waist. As ever, a surprising amount of information can be obtained by observing the patient before touching the patient. Bedside clues Look for evidence of the disease and its severity around the patient: • Inhalers? Which ones? • Any additional inhaler devices? • Nebulizer? • Is the patient receiving O 2 therapy? If so, how much and by what method (i.e., face mask, nasal cannula, etc.)? • Sputum container? Sputum-laden tissues? • Remember to inspect the sputum carefully and to record the fi ndings. • Any mobility aids nearby? • Look for cigarettes, lighter, or matches at the bedside or in a pocket. Respiration Watch the patient from the foot of the bed. Or watch them approach your clinic room. • Do they appear out of breath at rest? • If so, do they appear in distress? • Are they breathing through the mouth or the nose? • Are they breathing through pursed lips? (i the expiratory pressure—an indication of smoking-related lung disease) • If mobile, did they have to stop on the way to the room? How quickly did they recover? • Count the respiratory rate. At rest, this should be
Posted on: Thu, 23 Oct 2014 11:28:45 +0000
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