Question

Review of the respiratory system: YES/NO If yes, provide details: YES NO Details, if answered YES Allergies Asthma, wheezing Tobacco use Medications Cough Sputum production Hemoptysis Chest pain Shortness of breath Occupational risk factors Environmental risk factors Respiratory disease history Use of aerosols or inhalants Social History (occupational and home exposures, fitness activities, safety habits): __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Family history related to respiratory system: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Focused symptom analysis of current problem: Problem statement: _________________________________________________________________________________ Characteristics:_______________________________________________________________________________ Onset:______________________________________________________________________________________ Duration:____________________________________________________________________________________ Location:____________________________________________________________________________________ Severity:____________________________________________________________________________________ Associated problems:__________________________________________________________________________ Efforts to treat:_______________________________________________________________________________ Physical Assessment Vital Signs Temperature:____________ Pulse:__________________ Blood pressure: ___________________ Respirations (rate, rhythm, quality): _______________________________________________________ Inspection Skin (color, tone, texture):_______________________________________________________________ Thorax (shape, symmetry, movement, use of accessory muscles: _______________________________ _____________________________________________________________________________________ Breathing (rate, pattern, audible sounds):__________________________________________________ _____________________________________________________________________________________ Alertness:_____________________________________________________________________________ Nails (oxygenation, clubbing): ____________________________________________________________ Palpation Skin (temperature, tenderness, usual sensations):____________________________________________ _____________________________________________________________________________________ Trachea (position, mobility): _____________________________________________________________ Thoracic excursion (symmetry, anterior/posterior):___________________________________________ _____________________________________________________________________________________ Tactile fremitus (characteristics): _________________________________________________________ _____________________________________________________________________________________ Ribs and thorax (shape, symmetry, tenderness, masses):______________________________________ _____________________________________________________________________________________ Respiratory excursion (findings):__________________________________________________________ _____________________________________________________________________________________ Percussion Tones over thorax (describe tones and location): Anterior:_______________________________________________________________________ ______________________________________________________________________________ Posterior:______________________________________________________________________ ______________________________________________________________________________ Auscultation Breath sounds (describe breath sounds in all lung fields): Anterior:_______________________________________________________________________ ______________________________________________________________________________ Posterior:______________________________________________________________________ ______________________________________________________________________________ Lateral:________________________________________________________________________ ______________________________________________________________________________ Adventitious sounds (if present, describe):___________________________________________ ______________________________________________________________________________ Vocal Resonance (sound characteristics): _________________________________________________________ ___________________________________________________________________________________________ Analysis/Overall findings:______________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Answer 1

Yes

Family history:

Socio-economic status, second- hand smoke exposure, maternal smoking in pregnancy, wheezing complaints..family history of asthma important risk factors for asthma..

Focused symptoms:

Coughing especially at night, wheezing, shortness of breath, chest tightness, pain or pressure, feeling tired, trouble sleeping

Charecteristics:

Asthma charecterised by inflammation of the bronchial tubes with high production of secretion inside the tubes..people with asthma have symptoms when the airway obstructed and inflamed..

Onset:

When asthma symptoms appear and diagnosed in adults older than 20 years known as adult onset asthma.

Duration of asthma:

It can vary depending on causes and how long the airways have been inflamed..Mild attack will last only for few minutes,more severe last for more days and months.

Location:

Asthma occur in central airways in the distal lung and the lung parenchyma.

Severity:

In severe asthma symptoms like cough,tight chest and wheeze continue for daytime and there will be frequent nighttime symptoms also will be there..oxygen peak flow while exhaling less than 60% of maximum level.

Associated problems:

Cardiac asthma occur depends on how severity the asthma symptoms. Heart failure due to fluid collection in and around the airways.

Efforts to treat:

There are many effective medicine to treat asthma..IImmunotherapy can be helpful..corticosteroid for severe asthma .for immediate relief short acting inhaler beta2- agonist, anticholinergic will be effective..bronchodilators can expand the airways..