Physical assessment - Thorax and lungs: Nursing

Assessment of the thorax and lungs should be completed as part of a comprehensive assessment, like during a routine physical exam, or as part of a focused exam if a client is experiencing respiratory issues like shortness of breath, cough, or chest discomfort. Examination of the thorax and lungs gives the nurse information about the movement of air and gas exchange. Let’s review the process of completing thorax and lung assessment.

Okay, the supplies you’ll need for your assessment include a stethoscope, a washable pen or marker, a centimeter ruler, tape, drapes, and a good source of light.

Then, prepare for the exam by ensuring your client is in a comfortable position, that your hands and stethoscope are warm, and that the temperature in the room is comfortable. Provide privacy by closing the door and curtains, properly draping your client, and only exposing areas of their body as needed to perform your examination. Before getting started, explain the procedure to your client and be sure to answer any questions they might have before obtaining verbal consent. Then, perform hand hygiene and collect your supplies.

Now, locating the anatomical landmarks of the thorax and chest will help guide the appropriate placement of your equipment and hands throughout your assessment. The thorax can be divided into the anterior chest and posterior chest. Commonly used anterior landmarks include the sternum, clavicles, manubrium, xiphoid process, the ribs and intercostal spaces, and trachea, as well as the costal angle, which is made up of the the costal margins just below the xiphoid process. The chest can be further divided into sections using the midsternal line, a vertical line that runs down the middle of the sternum; and the right and left midclavicular lines, which are parallel to the midsternal line and run from the middle of each clavicle to around the 6th intercostal space. Posteriorly, the landmarks include the scapulae and thoracic spine. These lines are parallel to the spine and travel through the middle of the scapulae.