Nursing History for Lung Assessment
history of chronic hoarseness?
hoarseness indicates laryngeal disorder or abuse of cocaine or opioids
review family history for cancer, TB, allergies, or chronic obstructive pulmonary disease
patient @ risk for lung disease
review history for known or suspected HIV infection, substance abuse, low income, or being a resident or employee of nursing home or shelter, homeless, recent prison inmate, family member of TB patient, or immigrant to USA from a country where TB is prevalent
risk factors for TB
ask if patient has history of persistent cough, hemoptysis, unexplained weight loss, fatigue, night sweats or fever
risk factors for TB and HIV
assess history of tobacco or marijuana , including type of tobacco, duration and amount, age started, efforts to quit, and length of time since smoking stopped
smoking is a risk factor for lung cancer, heart disease, cerebrovascular disease, emphysema, or chronic bronchitis. it accounts for a significant percentage of all cancer deaths. it increases the risk for 15 types of cancer
ask if a patient has has a persistent cough, sputum streaked with blood, voice change, chest pain, shortness of breath, orthopnea, dyspnea during exertion or at rest, poor activity tolerance, or recurrent attacks of pneumonia or bronchitis
symptoms of cardiopulmonary alterations help localize objective physical findings. the diaphragm of the lungs expands more easily when the individual is sitting upright, as for patients who must be in an upright position to breathe
assess history of allergies to pollens, dust, or other airborne irritants and to foods, drugs, or chemical substances
symptoms such as choking feeling, bronchospasm with respiratory stridor, wheezes on auscultation, and dyspnea are often caused by allergic response
ask if patient has had a pneumonia or influenza vaccine and a Tb test; if not, educate him or her on need to do so
the very young, the very old, and those with chronic respiratory problems or immunosuppressive diseases are at increases risk for respiratory disease
determine if patient works in environment containing pollutants or requiring exposure to radiation. does patient have exposure to secondhand smoke?
these risk factors increase chance for various lung diseases