Nursing Lung Assessment

Download this Nursing Lung Assessment to understand the importance of assessing breath sounds, respiratory distress, and signs of respiratory diseases.

By Olivia Sayson on Aug 2, 2025.

Fact Checked by Nate Lacson.

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What is a Nursing Lung Assessment?

A lung assessment for nurses is critical to patient care, especially for those with respiratory concerns or underlying conditions. It involves a comprehensive and systematic evaluation of the respiratory system to determine lung function, identify abnormalities, and monitor overall respiratory health. Nurses conduct lung assessments to gather essential information that helps diagnose respiratory disorders, track treatment progress, and implement necessary interventions.

During a lung assessment, nurses examine various aspects of respiratory function, including breath sounds, chest movement, and patient-reported symptoms. The assessment helps nurses to:

Assess lung function: Evaluate the efficiency and effectiveness of the respiratory system in oxygenating the blood and removing carbon dioxide.
Detect abnormalities: Identify deviations from normal respiratory function, such as abnormal breath sounds, respiratory distress, or signs of respiratory diseases like COPD or asthma.
Monitor respiratory health: Monitor changes in respiratory status, track improvements or deterioration in lung function, and adjust treatment plans accordingly

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Respiratory disorders

Understanding common respiratory disorders is essential for healthcare providers involved in lung assessments and respiratory care. Some prevalent respiratory disorders include:

COPD (Chronic Obstructive Pulmonary Disease): A progressive lung disease characterized by airflow obstruction, chronic bronchitis, and emphysema, often resulting from long-term exposure to irritants such as cigarette smoke or environmental pollutants.
Asthma: A chronic inflammatory condition of the airways characterized by bronchospasm, airway inflammation, and increased mucus production, leading to recurrent episodes of wheezing, dyspnea, and coughing triggered by allergens, exercise, or environmental factors.
Pneumonia: An infection of the lung tissue caused by bacteria, viruses, or fungi, resulting in inflammation, consolidation, and impaired gas exchange, presenting with symptoms such as fever, cough, chest pain, and respiratory distress.
Bronchitis: Inflammation of the bronchial tubes, commonly caused by viral or bacterial infections, leading to cough, mucus production, and airway irritation, with acute bronchitis typically resolving within a few weeks and chronic bronchitis associated with long-term airway inflammation and mucus hypersecretion.

How to do a respiratory assessment?

Subjective assessment

Establish rapport with the patient and create a comfortable environment for open communication. Then, ask detailed questions about the patient's respiratory health history, including any past diagnoses, current symptoms, exacerbating factors, and impact on daily activities.

Inspection or observation

Observe the patient for signs of respiratory distress, including increased breathing work, nasal flaring, use of accessory muscles, and abnormal chest movements. Inspect the anterior and posterior chest walls for symmetry, shape, and visible abnormalities such as deformities or scars.

Palpation

Palpate the chest wall gently to identify areas of tenderness, abnormalities, or deformities. Assess tactile fremitus by placing hands on the chest wall while the patient vocalizes sounds to detect changes in vibrations indicative of lung pathology. Additionally, evaluate if the patient's chest makes bronchial breath sounds.

Auscultation

Use a stethoscope to auscultate breath sounds in different lung fields, including anterior, lateral, and posterior regions. Differentiate between normal breath sounds (e.g., bronchial, vesicular) and abnormal sounds (e.g., wheezes, crackles) that may signify underlying respiratory conditions.

Percussion

Perform percussion by tapping the chest wall with fingers to assess the resonance of lung tissue. Identify areas of dullness or hyper resonance, which may suggest underlying lung pathology or consolidation.

Voice sound assessment

Instruct the patient to say specific phrases while auscultating to evaluate sound transmission through lung tissue. Changes in the clarity or transmission of voice sounds can indicate lung density or consolidation alterations.

Normal findings

Normal findings indicate optimal respiratory function and overall lung health during a lung assessment. These include:

Clear and symmetrical breath sounds bilaterally: Auscultation reveals normal breath sounds, such as bronchial or vesicular, heard equally on both sides of the chest.
Absence of abnormal breath sounds or signs of respiratory distress: No adventitious lung sounds, such as wheezing, crackling, rhonchi, or stridor, are present. Additionally, the patient demonstrates comfortable breathing without visible signs of respiratory distress, such as increased breathing work or accessory muscle use.

Normal findings

Normal findings indicate optimal respiratory function and overall lung health during a lung assessment. These include:

Clear and symmetrical breath sounds bilaterally: Auscultation reveals normal breath sounds, such as bronchial or vesicular, heard equally on both sides of the chest.
Absence of abnormal breath sounds or signs of respiratory distress: No adventitious lung sounds, such as wheezing, crackling, rhonchi, or stridor, are present. Additionally, the patient demonstrates comfortable breathing without visible signs of respiratory distress, such as increased breathing work or accessory muscle use.

Abnormal findings

Presence of wheezes, crackles, or other adventitious lung sounds: Abnormal lung assessments may reveal the presence of adventitious lung sounds, including wheezes, crackles (also known as rales), rhonchi, or stridor. These sounds are abnormal breath sounds heard during auscultation and can indicate various underlying respiratory conditions:
Asymmetrical chest movement or abnormalities on palpation: Abnormalities in chest movement or palpation findings may indicate structural abnormalities, injury, or underlying respiratory conditions.