Respiratory System Examination in Children

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Table of Contents

Respiratory System: Description
Physiology: Structure and Function
Relevant Health History Questions
Objective Data and Expected Findings
Physical Assessment of Examination Techniques
Physical Assessment Skills
Disease That Can Affect the Respiratory System
Expected Abnormal Findings
Summary
References

Respiratory System: Description

The human respiratory system (RS) is known as the system of organs that allows obtaining oxygen from the air, delivering it to the necessary organs, and exhale carbon dioxide (CO2). The RS consists of the lungs, which maintain the continuous flow of oxygen and remove gaseous products from the human body (Kon & Rai, 2016). The RS also contains the airways, which are categorized into lower and upper ones, and which serve the purpose of pumping air, whereas the oxygen that it contains is delivered to specific organs with the help of red blood cells (Kon & Rai, 2016).

Despite the clockwork mechanism of the system, the RS is rather fragile since its performance can be disrupted once airways are blocked. The resulting experience of problems breathing and even possible suffocation may cause severe consequences from oxygen deprivation to death (Kon & Rai, 2016). Therefore, the case under analysis, which involves seemingly minor concerns, particularly, cough, needs in-depth analysis.

Physiology: Structure and Function

The upper respiratory tract consists of the nasal cavity, nostrils, pharynx, epiglottis, and larynx (Boore, Cook, & Shepherd, 2016). The lower respiratory tract, in turn, is composed of the trachea, esophagus, pulmonary vessels, intercostal muscles, left and right lungs, heart, bronchioles, the pleural membrane, alveoli, and the diaphragm (Boore et al., 2016). During the process of breathing, oxygen (O2) is converted into CO2. The latter, in turn, is transformed into HCO3 when transported from tissue cells to the lungs (Ward, ‎Ward, ‎& Leach, 2015). The process of HCO3 creation occurs as CO2 emitted from the lungs is combined with H2O to produce carbonic acid (H2CO3). The latter decomposes into HCO3 and H+ ions. The specified process is known as peripheral control, which is opposed to the central control.

Relevant Health History Questions

The current information concerning the health status of the patient does not allow making clear assumptions and diagnosing the problem. Therefore, a detailed assessment of the patient’s health history will be required. It is currently known that the patient is eight years old and that he has had a cough for five days. However, the root causes of the specified symptoms may vary from a minor respiratory inflammation caused by an infection to the early stage of asthma development. Therefore, further steps will have to be taken to determine the cause of the patient’s current condition. To define the factors that may have caused the cough, one may need to ask the patient or his mother the following questions:

Does the child have any known allergies?
Has the child been diagnosed with respiratory diseases such as asthma?
Has the child been exposed to cold recently?
When did the cough start?
What was the child doing when the cough started?
How can you describe the cough?

Objective Data and Expected Findings

Apart from relying on the evidence provided by the patient, a therapist will also have to perform several tests to locate the actual cause of the cough. For this purpose, the characteristics of a cough must be defined. For example, it will be necessary to check whether the cough is dry or productive. Also, a chest X-ray will allow determining whether the problem is caused by lung obstruction. Pulmonary function tests (PFTs) can be useful in case the problem turns out to be chronic (Sharafkhaneh, Yohannes, Hanania, & Kunik, 2017). Bronchial challenge testing and sinus imaging will have to be deployed if other methods of determining the problem prove to be futile. It is expected that the results of the patient assessment will point to a respiratory inflammation possibly caused by an infection.

Physical Assessment of Examination Techniques

As stressed above, a physician may need to run several tests to determine the factors that may have caused the issue. However, apart from the specified strategies, one will also need to use specific examination techniques. For example, the vital signs of the patient must be assessed. Also, a physician will have to revise all of the patient’s systems to ensure that the cause of the cough has been determined correctly and that no other factors affect its development. The specified step will have to be followed by the examination of the patient’s head, eyes, ears, nose, and throat. Also, a therapist will need to examine the patient’s neck and cardiovascular system to locate possible factors that may cause the cough.

Finally, chest examination as the most important step in the specified assessment process will be performed. The therapist will inspect and palpate the patient’s chest to locate the reasons for the cough to take place. The doctor will also have to evaluate the percussion of the lung fields along with the possible auscultation of the lungs. The specified checks will allow identifying the presence of wheezing, chest vibrations, and other characteristics of pulmonary obstruction that will allow defining the problem.

Physical Assessment Skills

To conduct the assessment, the therapist will have to use basic skills associated with the management of respiratory issues. Specifically, active observation will have to be used to identify the presence of a problem and explore its nature. Also, a therapist will require the ability to calculate the respiratory rate of the patient, examine his nasal cavity, and locate the presence of breathing problems such as wheezes and forced exhalation.

The specified skills can be used to accommodate the needs of infants by taking the fact that their airways are smaller into consideration. To manage the needs of pregnant women, one will have to assess abdominal muscle thickness as well. Finally, to address the health concerns of geriatric patients, one will need to consider the issues of comorbidity and frailty. Thus, a comprehensive assessment will be conducted.

Disease That Can Affect the Respiratory System

As stressed above, there is a range of diseases and disorders that may have caused the cough that is currently observed in the patient. Among the most common causes of the cough, one should mention asthma, common cold, and chronic obstructive pulmonary disease (COPD). The latter represents a combination of health issues that cause breathing issues (Boore et al., 2016). Therefore, the RS may have been affected by a vast variety of factors, and further tests will help to locate the actual cause of the cough.

Expected Abnormal Findings

The tests are most likely to return the results that will signify the presence of an infection, a common cold, or an allergic reaction that the patient must have suffered recently. The exposure to allergens may have triggered the fast development of the disease and, thus led to an unceasing cough. However, other causes of the problem may also be discovered in the course of the assessment since the current information is far too scarce to state the problem with certainty.

Summary

The case of a cough that was analyzed above lacks the data that could help define the presence of a particular issue straightaway. Thus, a therapist must perform further assessments to locate the cause of the issue and suggest the medications and treatment techniques that will help the patient. It is believed that the patient may have developed a common cold, asthma, or another respiratory issue that may have caused the problem to emerge. In any scenario, a detailed assessment of the patient’s health history and profound analysis of test results are required.

References

Boore, J., Cook, N., & Shepherd, A. (2016). Essentials of anatomy and physiology for nursing practice. Thousand Oaks, CA: SAGE.

Kon, C., & Rai, M. (2016). The microbiology of respiratory system infections. New York, NY: Academic Press.

Sharafkhaneh, A., Yohannes, A. M., Hanania, N. A., & Kunik, M. E. (2017). Depression and anxiety in patients with chronic respiratory diseases. New York, NY: Springer.

Ward, ‎J. P. T., Ward, J., ‎& Leach, R. M. (2015). The respiratory system at a glance (4th ed.). New York, NY: John Wiley & Sons.

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