Assessment of a Patient with Breathing Difficulty and Chest Pain

Running head: ASSESSMENT
Assessment
Name of the student:
Name of the University:
Author’s note

1ASSESSMENT
Introduction:
Mr. John is a 55 year old man, who was admitted to the emergency hospital last night
because of increase in breathlessness issues and worsening cough with productive sputum. Prior
to the hospital admission, he has been struggling with persistent cough and shortness of breath
from the past 4 days. However, last night his breathing difficult increases and it made him
difficult to even sit up. He became very anxious. For this reason, he was rushed to the hospital
immediately. Other symptoms found in patient during assessment include fatigue, fever and
sweating. The patient also complained that he is developing slight pain in his chest.
The review of his medical history suggests that he has been treated for bronchitis two
years ago. He is also a diabetic patient and takes medicine for hypertension. He is also a heavy
smoker taking 1 pack of cigarettes per day for the past 30 years. He lives with his family
members in a two bed room apartment. He has one son and one daughter who live in other town.
The vital sign assessment of Mr. John shows a blood pressure of 150/90 mmHg. Breathing rate is
17 breaths per minute (bpm) and heart rate is 110 bpm. The assessment of oxygen saturation
level shows oxygen saturation rate of 84% on room air and 98% on 4L nasal cannula.
A-E assessment:
Airway:
Airway assessment is important for patient to check whether patient is responsive or not
and there is any signs of respiratory obstruction or not. According to A-E assessment guideline
framed by Resuscitation Council UK (2014), conducting ‘Look, listen and feel’ test along with
assessment of signs of airway obstruction is important. The patient was alert and responsive,
however some changes in his voice was seen. Voice of patient and assessment of breath sound is

2ASSESSMENT
a vital part of airway assessment. While questioning Mr. John, it has been found that he is
speaking with difficulty and cannot complete full sentences. This indicates signs of airway
obstruction. Miller and Miller (2016) support that change in voice and increased breathing effort
is sign of partially obstructed airways. The assessment of breath sound of patient shows coarse
breath sounds and wheeziness.
Breathing:
Breathing assessment involves assessing the patient for signs of respiratory distress by
looking for signs of sweating, central cyanosis, use of accessory muscles and efforts taken during
breathing. It also involves assessment of pulse oximetry results, chest wall movements and lung
auscultation (Resuscitation Council UK 2014). The physical assessment of patient by ‘look,
listen and feel’ revealed sign of sweating and fatigue. His breathing rate was 17 breaths per
minute which is below the normal value and it is indicative of dyspnoea. The assessment of skin
revealed normal skin colour and no signs of cyanosis. His abdomen was slightly distended. On
lung auscultation, late inspiratory crackles and bilateral diminished breath sound was heard. The
pulse-oximetry reading revealed an oxygen saturation level of 84% on room air. The normal
oxygen saturation level is 95 to 100% and the oxygen saturation level lower than this is
indicative of need for supplemental oxygen for Mr. John
Circulation:
The basic responsibilities during circulation assessment involve assessment of capillary
refill time, pulse rate, heart auscultation and blood pressure. It also involves checking skin colour
and checking skin temperature (Thim et al. 2012). No changes in skin colour of Mr. John found.
However, his body temperature is 101 degree Fahrenheit, which is greater than the normal value.