Question: Getting a full and complete background of the patient before an assessment is important to know. Reviewing of systems and establishing a baseline of the systems is significant in treatment of their ailment/condition that are addressing. Observation of rate, rhythm, depth, and effort of breathing needs to be done after the heart sounds are heard. This is because with the cued breathing, the heart might increase in rate, and the nurse practitioner should assess for heart sounds at a resting rate. Evidence of respiratory distress at rest or when walking - eg, obvious breathlessness, talking in short phrases rather than full sentences, use of accessory muscles, exhalation with pursed lips (Henderson, 2015). Conpliance is the ability of the lungs to stretch. This mechanism plays the role in gas exchange in breathing. The more the lungs can stretch, the greater the potential volume of the lungs and the greater the volume of the lungs, the lower the air pressure within the lungs (Anatomy and Physiology, 2013).

During observation, if the patient has COPD, the breathing pattern might be different. Accessory muscle use signals difficulty breathing from COPD or respiratory muscle fatigue (Bickley, 2017). Other clinical observation can be that the COPD patient has delayed expiratory breaths. There might even be a possibility to see retractions with the COPD and asthma patients.