Respiratory Assessment

A respiratory assessment aims to evaluate the body's ability to maintain oxygenation through ventilation and gas exchange. Nurses must assess anatomy and function to recognize abnormalities in breath sounds or respiratory efforts across the life span.

Subjective assessment involves interviewing the patient about chronic conditions, medications, smoking habits, and current symptoms like dyspnea or cough. For patients ready to quit smoking, the '5 A's'—Ask, Advise, Assess, Assist, and Arrange—are utilized.

Objective assessment includes monitoring vital signs (respiratory rate and SpO2), observing breathing effort and skin color, checking for chest symmetry and configuration (e.g., barrel chest), and auscultating lungs. Key adventitious sounds include crackles, wheezes, stridor, and pleural rubs, which suggest fluid, obstruction, or inflammation.

Assessment techniques must be modified for pediatric patients (e.g., assessing resting rate while quiet) and older adults (e.g., accommodating limited chest expansion). Proper documentation necessitates clear description of both expected findings, such as clear lung sounds, and unexpected findings, such as retractions or abnormal oxygen saturation levels.