Respiratory and Cardiovascular Assessments

The ability to carry out and document a full respiratory and cardiovascular assessment is an essential skill. The severity of illness can be initially evaluated by inspection, palpation, percussion, and auscultation. During analysis, specific locations of symptoms can be identified using landmarks such as the midaxiallary, midclavicular, and, the midsternal line. Indicate anterior or posterior thorax, and use the midaxillary line location when applicable (Bickley & Szilagyi, 2013).

Respiratory Assessment

The two most common thorax deformities are funnel chest and barrel chest. Funnel chest describes a depressed sternum that increases pressure on the underlying organs and may result in changes in blood pressure or pulse rate. In contrast, barrel chest characterizes a rounded chest where the ribs are elevated, separated more than normal, and have an almost completely horizontal slope (Smeltzer, Bare, & Hinkle, 2010).

At the beginning of the gross examination, the patient should be comfortably seated on the edge of the bed to best visualize his or her thorax and breathing patterns. Visual inspection should first assess the respiratory rate, rhythm, depth, and effort, as well as any skin discolorations and gross deformities (e.g. curvatures and scars; Bickley & Szilagyi, 2013).

Palpation should measure chest expansion, tactile fremitus of the thorax during respirations, the intercostal spaces (for bulging or retractions), the presence of scars or other skin abnormalities (including skin tracts), skin temperature, tenderness, or pain. First palpate over the entire thorax surface starting at the top or bottom. Next, observe and palpate the posterior thorax using the same methodical approach (Bickley & Szilagyi, 2013).

Next, percu...

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... major precardial landmarks such as the aortic, pulmonary, Erb’s point, tricuspid, and mitral using the ball of the hand. Additionally, note the presence of any pulsations, thrills, and rubs.

Percussion is carried out when the patient is sitting in a vertical or horizontal position. Although this technique is of limited value in cardiac assessment, it can be used to determine the borders of cardiac dullness.

Abnormal Findings

Every year, about 9,000 women suffering from this condition are younger than 45 years. Less than half of these women were aware that this was the leading cause of death. 96% of women have prodromal symptoms such as unusual fatigue, sleep disturbances, shortness of breath, generalized pain/ discomfort, back pain, epigastric pain, dizziness, and frequent ingestion. Early recognition, diagnosis, and treatment are crucial for positive outcomes.