Assessment and examination of the respiratory system

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).