Clinical meaning
The RN's respiratory assessment follows a systematic approach integrating subjective data (dyspnea severity, triggers, alleviating factors) with objective findings (inspection, palpation, percussion, auscultation). Clinical deterioration follows a predictable trajectory: tachypnea → accessory muscle use → altered mental status → respiratory failure. Early recognition through protocolized assessment and use of early warning scores (MEWS, NEWS) enables timely intervention and prevents adverse outcomes.
Exam relevance
Risk factors: - Post-operative patients (atelectasis risk) - Patients receiving sedation or opioids - Neuromuscular disease - Morbid obesity - History of obstructive sleep apnea - Chest trauma - Immunocompromised patients
Diagnostics: - Perform systematic respiratory assessment using inspection, palpation, percussion, auscultation - Calculate NEWS/MEWS score for early warning detection - Monitor continuous pulse oximetry and capnography for high-risk patients - Assess cough strength and ability to protect airway - Evaluate sputum characteristics if productive - Perform focused assessment with any change in status - Correlate respiratory findings with hemodynamics and labs