You are seeing Mrs. Muller, a 45 year old female, in the ER for a new pneumonia. Please examine the patient and comment on his chest X-ray.
- Comments on presence of central/peripheral cyanosis (frenulum, lips, fingernails)
- Inspects for clubbing
- Comments on respiratory status – tachypnea /intercostal indrawing/accessory muscle use, etc.
- Examines for thoracic deformities
- Percusses in all anterior and posterior fields and comments on findings.
- Uses percussion to estimate diaphragmatic excursion on posterior.
- Instructs patient to breathe when auscultating
- States that they would auscultate both lung fields in at least 5 different locations
- Listens to at least one full breath at each location
- Auscultates posterior fields, asking patient to cross arms in order to shift scapulae out of lung fields.
- Comments on of breath sounds and presence of adventitious sounds
- Comment on abnormality on X-Ray
Case 4 – Pneumonia