Introduction

Nurses begin with assessments, including across-the-room (inspection) or head-to-toe (palpation, percussion, and auscultation) assessments, as part of the nursing process. As breathing and oxygen are vital to life, the pulmonary evaluation must take priority as it represents a significant initial part of every holistic client assessment. Any dysfunction in the respiratory system compromises vital gas exchange and poses a potential medical emergency and respiratory failure (National Institute of Health [NIH], 2022e). Respiratory problems lead to life-threatening consequences if not identified and managed promptly.

Consider this case: Kai is a 55-year-old Pacific Islander with a 30-year history of smoking. Kai works as a construction worker on the island of Kauai. He worked his way up to foreman and finds he works long hours, making fast food his main food option in the morning and evenings. During his time on the construction sites, he picked up the habit of smoking, which he has adamantly vowed to stop but has yet to succeed at. Kai is 6 feet tall and weighs 280 lb. When Kai was younger, he ate traditional Hawaiian foods that contained fish, rice, pork, and poultry with a wide variety of fresh fruits and vegetables.