iRubric: Chest/Lungs Assessment rubric

Verbalized observation for: 1. Color 2. Audible wheeze/rattle

and, if client presented with respiratory CC:
3. Cough, exudate, etc.

Performed step with confidence

Did not verbalize observation of the chest

Confidently palpated in appropriate areas AND verbalized findings for:
1.Condition of posterior chest wall skin & subcutaneous tissues
2. Thoracic expansion (@ Du7, thumbs lightly on skin OR thumbs create skin fold--watches thumbs)
3. Tactile fremitus (palpates bilaterally, starting T3-T5, uses ulnar dorsal or palmar surface, moving apex to base, 3 areas centrally 1 area lateral)
Appears confident in locating palpation stations, performing the palpations and verbalizing results.

Hesitated/did not appear confident
Performes all 3 assessments
Palpated in correct location/hand position correct
Verbalized results

Appeared unsure of how to proceed
Palpated and verbalized assessment of at least 2 areas
Hand position incorrect for 1 or more area

Assessed 1 area only
OR
Did not palpate
OR
Did not verbalize results

Confidently auscultated chest:
1. Posteriorly, 7 areas
2. Anteriorly, 6 areas
3. Symmetrically
4. Apex to base
5. Used bell at apex
6. Listened for full breath
7. Verbalized findings

Auscultated anterior and posterior chest, using 7-12 of the 13 listening posts
AND
Listened for a full breath
Verbalized findings
Hesitated or did not appear confident

Appeared unsure of how to proceed
Auscultated at least 6 listening posts, did not listen symmetrically,
AND/OR
Did not listen for a full breath
Did not verbalize findings

Auscultated fewer than 6 listening posts total, or did not auscultate the chest for lung sounds