Armstrong K. Taking a patient history as part of respiratory assessment. Journal of General Practice Nursing. 2019; 5:(3)40-46

Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Physical examination, 9th edn. Missouri: Elsevier; 2019

Blakeborough L, Watson JS. The importance of obtaining a sputum sample and how it can aid diagnosis and treatment. Br J Nurs. 2019; 28:(5)295-298

Demosthenous N. Consultation skills: a personal reflection on history-taking and assessment in aesthetics. Journal of Aesthetic Nursing. 2017; 6:(9)460-464

Fraser D. Physical assessment of the newborn: A comprehensive approach to the art of physical examination, 6th edn. In: Tappero EP, Honeyfield ME (eds). London: Springer Publishing Company; 2018

Fromage G. Medical records and history taking. Journal of Aesthetic Nursing. 2018; 7:(10)538-540

Hill AT, Gold PM, El Solh AA Adult outpatients with acute cough due to suspected pneumonia or influenza: CHEST guideline and expert panel report. Chest. 2019; 155:(1)155-167

Ingram S. Taking a comprehensive health history: learning through practice and reflection. Br J Nurs. 2017; 26:(18)1033-1037

Irwin RS, French CL, Chang AB Classification of cough as a symptom in adults and management algorithms: CHEST guideline and expert panel report. Chest. 2018; 153:(1)196-209

Jevon P, Epstein E, Mensforth S, MacMahon C. Medical student survival skills: Clinical examination, 1st edn. : Wiley-Blackwell; 2019

Lowth M. Recognising red flags. Practice Nurse. 2016; 46:(1)

McGee S. Evidence-Based Physical Diagnosis E-Book, 4th edn. : Elsevier; 2017

Malem A. Unequal pupils and ptosis. BMJ. 2017; 356

National Institute for Health and Care Excellence. How should I assess a person with cough?. 2021. (accessed 14 December 2021)

NHS. Main symptoms of coronavirus (COVID-19). 2021. (accessed 20 December 2021)

Nursing and Midwifery Council. The Code. Professional standards of practice and behaviour for nurses and midwives. 2018. (accessed 20 December 2021)

Respiratory Examination – OSCE guide. 2021. (accessed 14 December 2021)

Proctor J, Rickards E. How to perform chest auscultation and interpret the findings. Nurs Times. 2020; 116:(1)23-26

Ramanayake RJC, Basnayake BTK. Evaluation of red flags minimizes missing serious diseases in primary care. J Family Med Prim Care. 2018; 7:(2)315-318

Schroeder K, Chan WS, Fahey T. Recognising red flags in general practice. InnovAiT: Education and inspiration for general practice. 2011; 4:(3)171-176

Smith JA, Woodcock A. Chronic Cough. N Engl J Med. 2016; 375:(16)1544-1551

Assessment and examination of the respiratory system

02 January 2022
10 min read


Respiratory complaints are seen regularly in general practice. Eleanor Squires looks at the importance of advanced practitioners carrying out a systematic assessment and examination of a patient with respiratory symptoms

The aim of this article is to explore the importance of carrying out a systematic assessment and examination of a patient with respiratory complaints. History taking using recommended acronyms will be discussed, along with a focus on the most common presentations. Finally, it will discuss a systematic examination of the patient.

Respiratory complaints are seen regularly in practice but are often non-specific and can be caused by a variety of different conditions, both respiratory and non-respiratory. Advanced practitioners working in general practice are regularly faced with patients presenting with respiratory problems, either acute or chronic, so a proficiency in respiratory examinations is essential to assess and manage such conditions. It is also essential that advanced practitioners work in line with The Code (Nursing and Midwifery Council, 2018), recognising the limits of their own competence and appropriately referring to another practitioner when necessary. This article will focus on the assessment and examination of the respiratory system, while providing important information on receiving a history from a patient using useful acronyms. Key learning points will include common presentations and differential diagnoses, red flags, and further investigations.

Taking a patient history is an essential element in establishing a diagnosis and is used to get a deeper understanding of the patient's symptoms. The purpose of a systematic health history is to obtain important and detailed knowledge about the patient, their lifestyle, social supports, medical history, and health concerns, with the history of presenting illness as the focus (Ingram, 2017; Fromage, 2018). This enables the advanced practitioner to gather important information about the patient's underlying medical conditions and the reason they have attended, which will be valuable in formulating a diagnosis (Demosthenous, 2017).

Register now to continue reading

Thank you for visiting Practice Nursing and reading some of our peer-reviewed resources for general practice nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month