| Knowledge |
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States Relative Contraindications of procedure.
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| Preparation |
| Clinical Standards for Procedures and Interventions. |
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| Reviews respiratory history, recent imaging and laboratory data, current oxygen or ventilatory support, and applicable precautions; obtains a stethoscope and pulse oximeter. |
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| Positions the patient as upright as tolerated, preserves privacy, exposes only the areas required, and obtains baseline vital signs and oxygen saturation. |
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| Assessment |
| Inspects overall appearance, respiratory rate and pattern, depth, symmetry, ability to speak, accessory-muscle use, retractions, nasal flaring, paradoxical movement, cyanosis, and other signs of respiratory distress. |
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| Inspects anterior, lateral, and posterior chest shape and symmetry, anteroposterior diameter, deformity, scars, wounds, drains, tubes, and skin findings. |
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| Palpates tracheal position, chest-wall tenderness, masses, temperature, and subcutaneous crepitus while avoiding unnecessary pressure over painful or injured areas. |
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| Assesses bilateral chest expansion and, when clinically indicated, tactile fremitus by comparing symmetric locations. |
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| Percusses symmetric anterior, lateral, and posterior lung fields, comparing side to side for expected resonance and areas of dullness or hyperresonance. |
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| Auscultates symmetric lung fields from apices to bases over bare skin, asking the patient to breathe slowly and deeply through the mouth as tolerated. |
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| Identifies and describes breath-sound intensity and distribution and any crackles, wheezes, rhonchi, stridor, pleural rub, or diminished or absent sounds. |
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| Uses transmitted voice tests or other focused maneuvers only when indicated and interprets them with the complete clinical picture. |
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| Monitoring & Modifications |
| Immediately reports or responds to severe distress, stridor, unilateral absent breath sounds, rapidly worsening oxygenation, new tracheal deviation, or other findings suggesting an acute airway or thoracic emergency. |
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| Post-Intervention |
| Repositions the patient safely, restores clothing and bedding, cleans equipment, and reassesses comfort and oxygen delivery. |
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| Documents the examination sequence, respiratory effort, chest symmetry, percussion findings, breath sounds by location, oxygen support, oxygen saturation, and clinically significant actions or recommendations. |
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| Post-Intervention Management Steps. |
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