{"id":232,"date":"2021-08-28T02:26:54","date_gmt":"2021-08-28T06:26:54","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/objective-assessment\/"},"modified":"2024-06-06T11:06:22","modified_gmt":"2024-06-06T15:06:22","slug":"objective-assessment","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/objective-assessment\/","title":{"raw":"Objective Assessment","rendered":"Objective Assessment"},"content":{"raw":"<p style=\"text-align: left\"><span style=\"color: #000000\">An objective assessment of the respiratory system includes:<\/span><\/p>\r\n\r\n<ul>\r\n \t<li style=\"text-align: left\"><span style=\"color: #000000\"><strong>Brief scan<\/strong> of the respiratory system.<\/span><\/li>\r\n \t<li><span style=\"color: #000000\"><strong>Inspection<\/strong> and <strong>palpation<\/strong> of the <strong>nose <\/strong>and <strong>sinuses<\/strong>.<\/span><\/li>\r\n \t<li style=\"text-align: left\"><span style=\"color: #000000\"><strong>Inspection<\/strong>, <strong>auscultation<\/strong>, <strong>palpation<\/strong>, and<strong> percussion<\/strong> of the <strong>posterior<\/strong> and<strong> lateral thorax<\/strong> followed by the <strong>anterior thorax<\/strong>.<\/span><\/li>\r\n<\/ul>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">An objective assessment is usually completed after the subjective assessment, but if the client shows signs of respiratory distress, you may proceed directly to the objective assessment and associated interventions. In this case, it is important to prioritize care after a brief scan that involves components of the primary survey. The physical techniques of inspection and auscultation are usually prioritized.<\/span><\/p>\r\n<span style=\"color: #000000\">It is important to be aware of the landmarks of the anterior and posterior chest. This knowledge helps you accurately landmark and also informs the documentation of the findings. See <strong>Figure 2<\/strong>\u00a0for anatomical locations and <strong>Figure 3<\/strong>\u00a0for reference lines.<\/span>\r\n\r\n<img src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/09\/6.-Respiratory-Landmarks-755x1024.jpg\" alt=\"Anterior image of a naked person's chest. The chest has drawings of the clavicle, ribs, and anatomical descriptions.\" width=\"314\" height=\"440\" class=\"alignnone wp-image-586\" \/>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong>Figure 2<\/strong>: Anatomical landmarks.<\/span><\/p>\r\n<span style=\"color: #000000\">Photo by<\/span>\u00a0<a href=\"https:\/\/www.pexels.com\/@armin-rimoldi\">Armin Rimoldi<\/a>\u00a0<span style=\"color: #000000\">from<\/span>\u00a0<a href=\"https:\/\/www.pexels.com\/\">Pexels<\/a>\u00a0<span style=\"color: #000000\">(image was cropped and illustrated upon for the purposes of this chapter)<\/span>\r\n\r\n&nbsp;\r\n\r\n<img src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/11\/Anterior-Reference-Lines-649x1024.jpg\" alt=\"Anterior reference lines marked on a person's chest.\" width=\"229\" height=\"359\" class=\"alignnone wp-image-1344\" \/>\u00a0 \u00a0<img src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/11\/Posterior-Chest-Vertebral-And-Scapular-Lines-1024x734.jpg\" alt=\"A woman's posterior chest with the vertebral and scapular lines noted.\" width=\"423\" height=\"324\" class=\"alignnone wp-image-1345\" \/>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong>Figure 3<\/strong>: Reference lines.<\/span><\/p>\r\n<span style=\"color: #000000\">Image on left: Photo by<\/span>\u00a0<a href=\"https:\/\/www.pexels.com\/@armin-rimoldi\">Armin Rimoldi<\/a>\u00a0<span style=\"color: #000000\">from<\/span>\u00a0<a href=\"https:\/\/www.pexels.com\/\">Pexels<\/a>\u00a0<span style=\"color: #000000\">(image was cropped and illustrated upon for the purposes of this chapter)<\/span>\r\n\r\n<span style=\"color: #000000\">Image on right:\u00a0Photo by<\/span> <a href=\"https:\/\/www.pexels.com\/@laura-tancredi\">Laura Tancredi<\/a> <span style=\"color: #000000\">from<\/span> <a href=\"https:\/\/www.pexels.com\/\">Pexels<\/a> <span style=\"color: #000000\">(image was cropped and illustrated upon for the purposes of this chapter)<\/span>\r\n\r\n&nbsp;\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Be aware of the<strong> environmental temperature<\/strong> in the room and the temperature of your hands. Room temperatures are not easily modified, so you should attempt to limit exposing the client and keep them covered. You should also try to warm your hands and stethoscope before placing them on the client\u2019s body.<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Ensure the client is <strong>positioned<\/strong> in the best way to assess the lungs: usually <strong>seated<\/strong> or in the<strong> high-fowlers position<\/strong> with the client looking straight ahead so that the lungs can fully expand. If you are assessing a young child or newborn, you could ask someone (e.g., care partner, healthcare provider, parent) to help hold the client upright on the exam table or sit the client in their lap while assessing the respiratory system.<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">You should help the client into the side-lying position if they are in a supine position and cannot sit upright. This repositioning may require the help of another healthcare provider if the client is unable to roll over themselves.<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Assessment of the<strong> posterior<\/strong> and <strong>lateral thorax<\/strong> involves assessing from the shoulders and the axillary area down to the bottom of the rib cage. Assessment of the<strong> anterior thorax<\/strong> involves assessing from the lung apices (just above the clavicles) down to the bases (at bottom of the rib cage). To help visualize, see <strong>Figure 4<\/strong>\u00a0for the location of the lobes on the anterior and posterior thorax and <strong>Figure<\/strong> <strong>5<\/strong> for the location of the lobes on the lateral thorax (shown upon inspiration).<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Keep in mind, you should do the entire assessment on the <strong>bare skin<\/strong>.<\/span><\/p>\r\n<img src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/11\/Respiratory-Anterior-black-background-225x300.jpg\" alt=\"A man's anterior chest with lungs, including lobes and landmarks drawn onto image and noted.\" width=\"225\" height=\"300\" class=\"alignnone size-medium wp-image-1346\" \/> <img src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/09\/3.Respiratory-Posterior-225x300.jpg\" alt=\"Posterior image of a naked person's back. The back has drawings of the left upper and lower lobes, as well as the right upper, middle, and lower lobes including the oblique fissures.\" width=\"225\" height=\"300\" class=\"alignnone size-medium wp-image-584\" \/>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong>Figure 4<\/strong>: Location of lobes on anterior and posterior thorax.<\/span><\/p>\r\n&nbsp;\r\n\r\n<img src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/11\/Left_Lateral_Lung_Lobes-final-225x300.jpg\" alt=\"A man's left lateral chest with lungs, including lobes and landmarks drawn onto image and noted.\" width=\"225\" height=\"300\" class=\"alignnone size-medium wp-image-1378\" \/> <img src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/11\/Right_Lateral_Lung_Lobes-final-225x300.jpg\" alt=\"A man's right lateral chest with lungs, including lobes and landmarks drawn onto image and noted.\" width=\"225\" height=\"300\" class=\"alignnone size-medium wp-image-1447\" \/>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong>Figure 5<\/strong>: Location of lobes on lateral thorax.<\/span><\/p>\r\n&nbsp;\r\n<div class=\"textbox textbox--examples\"><header class=\"textbox__header\">\r\n<h2 class=\"textbox__title\" style=\"text-align: center\">Clinical Tip<\/h2>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Always use a <strong>trauma-informed approach<\/strong> to inform your respiratory assessment. This is particularly important considering that areas of the chest will be exposed. Do not assume who may have experienced trauma: it can happen to anyone, regardless of gender, age, or socioeconomic\/educational level.<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">You could start by asking the client if they would like a family member or friend present or another healthcare provider. You should explain what you are doing throughout the assessment and explain why these actions are important to perform. Sometimes it is helpful to show on your own chest (over your uniform) where you will be palpating and placing your hands or the stethoscope.<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">Maintain privacy by closing the door and\/or curtains. Use draping and only expose the necessary areas of the chest. Clients may feel awkward or embarrassed having their thorax exposed, particularly the anterior side. This feeling can be felt by people of all genders and ages. While you have the gown open at the back, use the drape to cover the lower half of the thorax. When you need to assess the anterior thorax, use the drape to cover any area not being assessed; the drape can be secured around the abdomen. With the anterior thorax, you can ask the client to lower the patient gown at the top so that you can assess the upper thorax and then, you can have them pull the gown up at the bottom to assess the lower thorax. Another alternative method is to have gown open at the front instead of the back.<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">You should always be professional, confident, and efficient. Try to be responsive to the client\u2019s verbal and non-verbal cues. If they seem uncomfortable, you could acknowledge this by saying, \u201cMany clients feel uncomfortable having their lungs assessed because it involves exposing their chest. I will only ask you to expose the areas that I need to assess and then you can cover back up again. Is there anything I can do to make this easier for you?\u201d<\/span><\/p>\r\n\r\n<\/div>\r\n<\/div>\r\n<div class=\"textbox shaded\">\r\n<h2 style=\"text-align: center\"><span style=\"color: #000000\">Contextualizing Inclusivity - Chest Binding<\/span><\/h2>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">An inclusive approach to health assessment is vital because clients need to feel accepted for who they are. Some non-binary and transmasculine clients may wear a chest binder because they feel uncomfortable or distressed about having breast tissue. Binders are garments designed to flatten the appearance of the chest wall. They come in different forms and can extend from the chest down to the diaphragm or to the hips: they may look like a sports bra or tank top, and some clients may use compression bandage.<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">The binder needs to be removed to adequately listen to the lungs, as these sounds may be diminished through the binder. You may or may not be aware of whether the client you are assessing wears a chest binder, so you can apply an inclusive approach by acknowledging the vulnerability that clients may feel. Provide step-by-step instructions so that they are prepared, and ask non-judgmental questions like \u201cAssessing your lungs requires me to assess on the bare skin on the front and back of your chest. Is there anything that would impede me from doing so?\u201d You can also ask if they have any questions before beginning such as \u201cDo you have any questions before we begin?\u201d<\/span><\/p>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">You should also assess the binder for proper fit: a good fit allows for normal chest expansion and deep breathing.<\/span><\/p>\r\n\r\n<\/div>\r\n&nbsp;","rendered":"<p style=\"text-align: left\"><span style=\"color: #000000\">An objective assessment of the respiratory system includes:<\/span><\/p>\n<ul>\n<li style=\"text-align: left\"><span style=\"color: #000000\"><strong>Brief scan<\/strong> of the respiratory system.<\/span><\/li>\n<li><span style=\"color: #000000\"><strong>Inspection<\/strong> and <strong>palpation<\/strong> of the <strong>nose <\/strong>and <strong>sinuses<\/strong>.<\/span><\/li>\n<li style=\"text-align: left\"><span style=\"color: #000000\"><strong>Inspection<\/strong>, <strong>auscultation<\/strong>, <strong>palpation<\/strong>, and<strong> percussion<\/strong> of the <strong>posterior<\/strong> and<strong> lateral thorax<\/strong> followed by the <strong>anterior thorax<\/strong>.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: left\"><span style=\"color: #000000\">An objective assessment is usually completed after the subjective assessment, but if the client shows signs of respiratory distress, you may proceed directly to the objective assessment and associated interventions. In this case, it is important to prioritize care after a brief scan that involves components of the primary survey. The physical techniques of inspection and auscultation are usually prioritized.<\/span><\/p>\n<p><span style=\"color: #000000\">It is important to be aware of the landmarks of the anterior and posterior chest. This knowledge helps you accurately landmark and also informs the documentation of the findings. See <strong>Figure 2<\/strong>\u00a0for anatomical locations and <strong>Figure 3<\/strong>\u00a0for reference lines.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/09\/6.-Respiratory-Landmarks-755x1024.jpg\" alt=\"Anterior image of a naked person's chest. The chest has drawings of the clavicle, ribs, and anatomical descriptions.\" width=\"314\" height=\"440\" class=\"alignnone wp-image-586\" \/><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong>Figure 2<\/strong>: Anatomical landmarks.<\/span><\/p>\n<p><span style=\"color: #000000\">Photo by<\/span>\u00a0<a href=\"https:\/\/www.pexels.com\/@armin-rimoldi\">Armin Rimoldi<\/a>\u00a0<span style=\"color: #000000\">from<\/span>\u00a0<a href=\"https:\/\/www.pexels.com\/\">Pexels<\/a>\u00a0<span style=\"color: #000000\">(image was cropped and illustrated upon for the purposes of this chapter)<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/11\/Anterior-Reference-Lines-649x1024.jpg\" alt=\"Anterior reference lines marked on a person's chest.\" width=\"229\" height=\"359\" class=\"alignnone wp-image-1344\" \/>\u00a0 \u00a0<img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/11\/Posterior-Chest-Vertebral-And-Scapular-Lines-1024x734.jpg\" alt=\"A woman's posterior chest with the vertebral and scapular lines noted.\" width=\"423\" height=\"324\" class=\"alignnone wp-image-1345\" \/><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong>Figure 3<\/strong>: Reference lines.<\/span><\/p>\n<p><span style=\"color: #000000\">Image on left: Photo by<\/span>\u00a0<a href=\"https:\/\/www.pexels.com\/@armin-rimoldi\">Armin Rimoldi<\/a>\u00a0<span style=\"color: #000000\">from<\/span>\u00a0<a href=\"https:\/\/www.pexels.com\/\">Pexels<\/a>\u00a0<span style=\"color: #000000\">(image was cropped and illustrated upon for the purposes of this chapter)<\/span><\/p>\n<p><span style=\"color: #000000\">Image on right:\u00a0Photo by<\/span> <a href=\"https:\/\/www.pexels.com\/@laura-tancredi\">Laura Tancredi<\/a> <span style=\"color: #000000\">from<\/span> <a href=\"https:\/\/www.pexels.com\/\">Pexels<\/a> <span style=\"color: #000000\">(image was cropped and illustrated upon for the purposes of this chapter)<\/span><\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">Be aware of the<strong> environmental temperature<\/strong> in the room and the temperature of your hands. Room temperatures are not easily modified, so you should attempt to limit exposing the client and keep them covered. You should also try to warm your hands and stethoscope before placing them on the client\u2019s body.<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">Ensure the client is <strong>positioned<\/strong> in the best way to assess the lungs: usually <strong>seated<\/strong> or in the<strong> high-fowlers position<\/strong> with the client looking straight ahead so that the lungs can fully expand. If you are assessing a young child or newborn, you could ask someone (e.g., care partner, healthcare provider, parent) to help hold the client upright on the exam table or sit the client in their lap while assessing the respiratory system.<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">You should help the client into the side-lying position if they are in a supine position and cannot sit upright. This repositioning may require the help of another healthcare provider if the client is unable to roll over themselves.<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">Assessment of the<strong> posterior<\/strong> and <strong>lateral thorax<\/strong> involves assessing from the shoulders and the axillary area down to the bottom of the rib cage. Assessment of the<strong> anterior thorax<\/strong> involves assessing from the lung apices (just above the clavicles) down to the bases (at bottom of the rib cage). To help visualize, see <strong>Figure 4<\/strong>\u00a0for the location of the lobes on the anterior and posterior thorax and <strong>Figure<\/strong> <strong>5<\/strong> for the location of the lobes on the lateral thorax (shown upon inspiration).<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">Keep in mind, you should do the entire assessment on the <strong>bare skin<\/strong>.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/11\/Respiratory-Anterior-black-background-225x300.jpg\" alt=\"A man's anterior chest with lungs, including lobes and landmarks drawn onto image and noted.\" width=\"225\" height=\"300\" class=\"alignnone size-medium wp-image-1346\" \/> <img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/09\/3.Respiratory-Posterior-225x300.jpg\" alt=\"Posterior image of a naked person's back. The back has drawings of the left upper and lower lobes, as well as the right upper, middle, and lower lobes including the oblique fissures.\" width=\"225\" height=\"300\" class=\"alignnone size-medium wp-image-584\" \/><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong>Figure 4<\/strong>: Location of lobes on anterior and posterior thorax.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/11\/Left_Lateral_Lung_Lobes-final-225x300.jpg\" alt=\"A man's left lateral chest with lungs, including lobes and landmarks drawn onto image and noted.\" width=\"225\" height=\"300\" class=\"alignnone size-medium wp-image-1378\" \/> <img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pressbooks.library.ryerson.ca\/assessmentnursing\/wp-content\/uploads\/sites\/192\/2021\/11\/Right_Lateral_Lung_Lobes-final-225x300.jpg\" alt=\"A man's right lateral chest with lungs, including lobes and landmarks drawn onto image and noted.\" width=\"225\" height=\"300\" class=\"alignnone size-medium wp-image-1447\" \/><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\"><strong>Figure 5<\/strong>: Location of lobes on lateral thorax.<\/span><\/p>\n<p>&nbsp;<\/p>\n<div class=\"textbox textbox--examples\">\n<header class=\"textbox__header\">\n<h2 class=\"textbox__title\" style=\"text-align: center\">Clinical Tip<\/h2>\n<\/header>\n<div class=\"textbox__content\">\n<p style=\"text-align: left\"><span style=\"color: #000000\">Always use a <strong>trauma-informed approach<\/strong> to inform your respiratory assessment. This is particularly important considering that areas of the chest will be exposed. Do not assume who may have experienced trauma: it can happen to anyone, regardless of gender, age, or socioeconomic\/educational level.<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">You could start by asking the client if they would like a family member or friend present or another healthcare provider. You should explain what you are doing throughout the assessment and explain why these actions are important to perform. Sometimes it is helpful to show on your own chest (over your uniform) where you will be palpating and placing your hands or the stethoscope.<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">Maintain privacy by closing the door and\/or curtains. Use draping and only expose the necessary areas of the chest. Clients may feel awkward or embarrassed having their thorax exposed, particularly the anterior side. This feeling can be felt by people of all genders and ages. While you have the gown open at the back, use the drape to cover the lower half of the thorax. When you need to assess the anterior thorax, use the drape to cover any area not being assessed; the drape can be secured around the abdomen. With the anterior thorax, you can ask the client to lower the patient gown at the top so that you can assess the upper thorax and then, you can have them pull the gown up at the bottom to assess the lower thorax. Another alternative method is to have gown open at the front instead of the back.<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">You should always be professional, confident, and efficient. Try to be responsive to the client\u2019s verbal and non-verbal cues. If they seem uncomfortable, you could acknowledge this by saying, \u201cMany clients feel uncomfortable having their lungs assessed because it involves exposing their chest. I will only ask you to expose the areas that I need to assess and then you can cover back up again. Is there anything I can do to make this easier for you?\u201d<\/span><\/p>\n<\/div>\n<\/div>\n<div class=\"textbox shaded\">\n<h2 style=\"text-align: center\"><span style=\"color: #000000\">Contextualizing Inclusivity &#8211; Chest Binding<\/span><\/h2>\n<p style=\"text-align: left\"><span style=\"color: #000000\">An inclusive approach to health assessment is vital because clients need to feel accepted for who they are. Some non-binary and transmasculine clients may wear a chest binder because they feel uncomfortable or distressed about having breast tissue. Binders are garments designed to flatten the appearance of the chest wall. They come in different forms and can extend from the chest down to the diaphragm or to the hips: they may look like a sports bra or tank top, and some clients may use compression bandage.<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">The binder needs to be removed to adequately listen to the lungs, as these sounds may be diminished through the binder. You may or may not be aware of whether the client you are assessing wears a chest binder, so you can apply an inclusive approach by acknowledging the vulnerability that clients may feel. Provide step-by-step instructions so that they are prepared, and ask non-judgmental questions like \u201cAssessing your lungs requires me to assess on the bare skin on the front and back of your chest. Is there anything that would impede me from doing so?\u201d You can also ask if they have any questions before beginning such as \u201cDo you have any questions before we begin?\u201d<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"color: #000000\">You should also assess the binder for proper fit: a good fit allows for normal chest expansion and deep breathing.<\/span><\/p>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"author":34,"menu_order":4,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by-nc"},"chapter-type":[],"contributor":[72],"license":[56],"class_list":["post-232","chapter","type-chapter","status-publish","hentry","contributor-december-2021","license-cc-by-nc"],"part":224,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/232","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/users\/34"}],"version-history":[{"count":3,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/232\/revisions"}],"predecessor-version":[{"id":2653,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/232\/revisions\/2653"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/parts\/224"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/232\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/media?parent=232"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapter-type?post=232"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/contributor?post=232"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/license?post=232"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}