There are important issues that are considered by nurses when assessing the thorax and lungs of patients and interpreting the findings. The scenario’s special considerations include visual inspection and patient history. The nurse should begin by inspecting the patient visually since it makes it easier to detect most abnormalities through thorax inspection when the patient breathes. Besides, it helps to detect breathing pattern issues. The nurse can assess the deformities like curvatures, breathing rate and many others through visual inspection. Also, the nurse can identify the existence of mental struggles, including lethargy resulting from pain and respiratory difficulty indicators (“Pneumothorax – Diagnosis and treatment – Mayo Clinic”, 2021).
Palpation is the initial assessment step in which the patient is examined through touching. It is a significant step for identifying several breathing difficulties. Both systematic and mechanical respiratory complications are detectable during this period. The nurse palpated the following during the assessment: the thorax’s shape and size while breathing, intercostal spaces, scars, skin problems, and many others. Percussion is used to showing abnormalities; it involves chest striking and is effective only for 7cm depth. It will help in determining if fluids are present in the underlying tissues. Lastly, the nurse can use auscultation to determine the airflow complications through the trachea. The nurse should consider the breathing quality and intensity, including rate, rhythm, and adventitious sounds. These may result from hypoventilation (“Pneumothorax – Diagnosis and treatment – Mayo Clinic”, 2021).
According to the scenario, the findings can be interpreted as follows; the elevated respiratory rate may be due to trauma. Trauma resulting from injury caused by accident activates the sympathetic nervous system (Korymasov et al., 2021). The patient may experience asymmetric chest expansion due to the following reasons, thoracic wall deformities, which may result from factors like rib fracture. Also, the diminished lung sound on the left may be due to fluid and air in the lungs. Based on the scenario, the primary diagnosis for lungs and thorax is a chest X-ray (“Pneumothorax – Diagnosis and treatment – Mayo Clinic”, 2021). Besides, the nurse may require computerised tomography to provide detailed images. Ultrasound imaging is also significant for diagnosing chest and thorax.
Challenges may be encountered in the process of thorax and lung assessment. For instance, based on the scenario, in history taking a step, the patient may fail to give accurate information concerning the thorax and lung-related complications (Reyes et al., 2022). Besides, there may be difficulty in physically assessing the patient since the individual may prefer privacy to be upheld. Lastly, the findings may be inaccurate due to false information provided by the patient. The unavailability of required tools for patient diagnosis is also a significant challenge (Korymasov et al., 2021). The nurse may come up with various ways to help overcome the challenge. For instance, assuring the patient that the shared information will remain undisclosed will help to attain fine details of how the patient is feeling. Also, prior ordering of the required equipment will be appropriate.
References
Korymasov, E., Benian, A., Bogdanova, J., Kolmakova, K., Medvedchikov-Ardiia, M., & Konovalova, D. (2021). Challenges in diagnosis and treatment of pneumothorax and giant bullae. PULMONOLOGY, 31(4), 499-504. https://doi.org/10.18093/0869-0189-2021-31-4-499-504
Pneumothorax – Diagnosis and treatment – Mayo Clinic. Mayoclinic.org. (2021). Retrieved 21 September 2022, from https://www.mayoclinic.org/diseases-conditions/pneumothorax/diagnosis-treatment/drc-20350372.
Reyes, F., Modi, P., & Le, J. (2022). Lung Exam. Ncbi.nlm.nih.gov. Retrieved 21 September 2022, from https://www.ncbi.nlm.nih.gov/books/NBK459253/.
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