Technique

• Count respiratory rate for a full minute while observing pattern and effort; note any irregular pattern (for example Cheyne-Stokes or Kussmaul).
• Auscultate anterior, lateral, and posterior fields bilaterally from apex to base with the diaphragm, comparing side to side.
• Assess SpO2 with an adequate waveform and perfusion; document the device and flow (room air, or the liter flow and delivery method).
• Observe inhaler and spacer steps and nebulizer technique directly rather than relying on report.
• Assess chest-expansion symmetry by hand placement; note whether the patient speaks in full sentences.
• Perform pre- and post-bronchodilator or nebulizer monitoring (respiratory rate, SpO2, and breath sounds).