CHEAT SHEET
RESPIRATORY
ASSESSMENT
Hey there, friend!
It can be super challenging to learn how to assess a patient.
And the respiratory assessment??
That’s like, DOUBLE challenging.
When I was in nursing school I would always second guess myself when it came to
breath sounds. And let’s be honest, I had no idea where to put my stethoscope.
So if you’re like me, don’t worry, I’ve got you covered.
In this cheat sheet, I’ll walk you through the respiratory assessment, step-by-step.
Here’s what’s included:
1. Health History Questions
2. Inspection
3. Palpation
4. Percussion
5. Auscultation
6. Checklist
And if you need more help with nursing fundamentals, be sure to check out this playlist
on YouTube.
All my best,
Christina
Respiratory NursingSOS
LEGAL DISCLAIMER: This cheat sheet is intended for educational purposes only. This is not medical advice and errors
may occur. Never treat a patient or make a nursing or medical decision based solely on the information provided in
this cheat sheet. Never practice nursing or medicine unless you have a proper license to do so.
RESPIRATORY ASSESSMENT
CHEAT SHEET
HEALTH HISTORY QUESTIONS
1. Are you having any chest pain or have you had chest pain recently?
a. Chest pain is serious, and it is important to alert the RN to this.
2. Are you having shortness of breath or have you had shortness of breath
recently?
3. Ask about their cough:
a. Have you had a cough lately?
b. Is it productive? If so, what color and consistency is the sputum?
4. Do you use oxygen, CPAP, or BiPAP?
If the patient responds with yes to any of these questions (except number 4), make
sure to ask when the problem started, what leads up to it, what (if anything) relieves
it, and if they have taken any medications for it.
INSPECTION
Inspection is everything that you see or notice about the patient without actually
touching them, such as respiratory effort and chest expansion symmetry. The
primary things you will want to notice are:
1. Chest movement:
a. Is it symmetrical?
b. Is one side expanding more than the other?
c. Is one part of the rib cage expanding or collapsing unevenly?
2. How fast are they breathing?
a. Count their respirations for a full minute. This gives you their respiratory
rate.
3. Is their inhale and exhale equal duration or is one longer than the other?
a. Exhalation is typically about twice as long as inhalation.
b. This is known as respiratory rhythm.
4. Are they elevating their shoulders, chest or tummy in order to breathe?
a. This may indicate accessory muscles use and labored breathing.
PALPATION
Palpation for the respiratory system can be used to locate painful areas, crackles
under the skin that are caused by a leak in the lung (crepitus) as well as to feel the
symmetry of the rib cage.
2
Respiratory NursingSOS
1. Move the tips of your fingers or palm of your hand up and down over the
patient’s chest, pressing and lifting as you go.
a. Notice any lumps, bumps, tenderness, or abnormal sounds.
PERCUSSION
Percussion involves tapping your fingers along the patient’s body in order to identify
dense areas or masses, fluid filled areas, or area filled areas.
1. Place your non dominant hand's middle finger on the patient’s chest and tap the
knuckle closest to the fingernail with the middle finger of your dominant hand.
a. Use a Z-block pattern: 10 places in the front and 18 places on the back.
i. Some schools may have you do different placements for percussion. So
check with your clinical and skills instructor first.
AUSCULTATION
Auscultation means that you are listening to the patient's body, typically using your
stethoscope.
This will help you identify areas with less air movement than others, as well as
crackles, wheezes, rhonchi, stridor, pleural rub and the location of breath sounds.
1. Place your stethoscope in 8 places in the front and 10 places on the back moving
in a Z-block pattern.
a. Some schools may have you do different placements for auscultation. So
check with your clinical and skills instructor first.
b. Press the stethoscope firmly on the patient’s chest and have them take deep
breaths through their mouth.
2. Listen for a full respiratory cycle (one inhalation and one exhalation) at each
placement.
a. It is important to listen for a full respiratory cycle because abnormal sounds
may only appear during either inhalation or exhalation.
3
RESPIRATORY ASSESSMENT
CHEAT SHEET
CHECKLIST
Health History Questions
Have you had any chest pain?
Have you had any shortness of breath?
Have you had a cough lately?
Do you use oxygen, CPAP, or BiPAP?
Inspection
Is their chest movement symmetrical?
What is their respiratory rate?
What is their respiratory rhythm?
Is their breathing labored?
Palpation
Is there any pain, lumps or abnormal sounds?
Percussion
Use a Z-block pattern: 10 places in the front and 18 places in the back
Describe the tone you hear.
Auscultation
Use a Z-block pattern: 8 places in the front and 10 places in the back
Do you hear crackles, wheezes, rhonchi, stridor, or a pleural rub?
