Determination of a client's chest excursion involves:
A. Symmetrical thoracic auscultation
B. Observation of respiratory efforts
C. Percussion over air-filled regions
D. Palpation of movement during a deep breath
D
A, B, C, D. Standing behind client, place thumbs along the spinal processes at the tenth rib, with the palms lightly contacting the posterolateral surfaces (see illustration A). The nurse's thumbs should be about 2 inches (5 cm) apart, with the thumbs pointing toward the spine and the fingers pointing laterally. Press hands toward client's spine to form small skinfold between thumbs. After exhalation, client takes deep breath. Note movement of thumbs (see illustration B), and note symmetry of chest wall movement. Normally symmetrical separation of the thumbs occurs during chest excursion.
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