Lung Sounds and Pattern

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Questions and Answers

What is the main purpose of using a pattern while assessing lung sounds?

To ensure you don't miss any areas of the lung (correct)
To identify the source of adventitious sounds
To compare lung sounds with those from a previous examination
To assess the patient's respiratory rate

What type of lung sound is typically loudest over the peripheral lung fields?

Bronchial sound
Bronchovesicular sound
Vesicular sound (correct)
Wheeze-sonorous rhonchi

What is the normal range of respiratory rate for an adult?

12-20 breaths per minute (correct)
15-25 breaths per minute
18-22 breaths per minute
10-18 breaths per minute

What type of adventitious sound is characterized by a high-pitched crackling sound?

Fine crackles (B) Signup and view all the answers

What is the normal range of arterial oxygen saturation (SPO2) as measured by pulse oximetry?

97%-99% (C) Signup and view all the answers

What is the term for the sound produced by friction in pleural tissue due to inflammation?

Pleural friction fremitus (C) Signup and view all the answers

What is the term for an obstruction in the upper airway, often caused by something lodged in the throat, commonly seen in children?

Stridor (A) Signup and view all the answers

What type of lung sound is typically louder than vesicular sounds and heard closest to the bronchi?

Bronchovesicular sound (A) Signup and view all the answers

What is the normal respiratory rate in an adult?

12-20 (B) Signup and view all the answers

What is the significance of a patient using accessory muscles of respiration?

It indicates labored breathing. (A) Signup and view all the answers

What is the normal finding in a lung examination regarding temperature?

Warm (D) Signup and view all the answers

During a lung examination, where should the hands be placed on the mid back?

In a W shape (C) Signup and view all the answers

What is the normal chest wall configuration in a healthy adult?

AP:T is 1:2 (C) Signup and view all the answers

What is the significance of clubbing in the nails?

It is a sign of chronic hypoxia. (C) Signup and view all the answers

What is the purpose of the hands moving when the patient is breathing in and out during a lung examination?

To assess symmetric chest expansion (D) Signup and view all the answers

What is the purpose of the patient saying '99, 99' and 'blue moon' during a lung examination?

To generate vibrations from the larynx (D) Signup and view all the answers

What is the significance of a patient sitting in a tripod position?

It is a sign of hypoxia or COPD. (D) Signup and view all the answers

What is the significance of dorsal curvature in the posterior thorax?

It is a sign of kyphosis or gibbus, which can impede on respirations. (A) Signup and view all the answers

What should the patient be positioned during a percussion examination?

Slightly bent forward (B) Signup and view all the answers

What is the purpose of palpation in lung assessment?

To assess the lung expansion. (C) Signup and view all the answers

What is a normal finding during a percussion examination?

Resonant sound (C) Signup and view all the answers

What is the significance of cyanosis in the skin?

It is a sign of chronic hypoxia. (A) Signup and view all the answers

Why do we hear different sounds when percussing over bones than over lung tissue?

Because bones are denser than lung tissue (B) Signup and view all the answers

How should the patient breathe during an auscultation examination?

In and out through the mouth (A) Signup and view all the answers

What is one of the major functions of respiration?

Supplying O2 to the body for energy (A) Signup and view all the answers

What does the 'A' in ABC stand for?

Airway (D) Signup and view all the answers

When should a patient's lungs be assessed?

Every shift with every patient (C) Signup and view all the answers

What is the ideal position for a patient during lung assessment?

Sitting in a relaxed position (A) Signup and view all the answers

What is the primary component of a neurologic examination?

Mental status (C) Signup and view all the answers

What can cause inaccurate readings in oxygen saturation?

Carbon monoxide binding to Hgb or anemia (A) Signup and view all the answers

What is the range of scores for the Glasgow Coma Scale?

3-15 (D) Signup and view all the answers

What is the primary purpose of percussion of the lungs?

To aid in determining if lung tissue is healthy in an adult (D) Signup and view all the answers

What is the primary purpose of assessing a patient's level of consciousness?

To quantify their neurologic status (D) Signup and view all the answers

What type of sound is typically found in healthy lung tissues in an adult?

Low-pitched, clear, hollow sound (A) Signup and view all the answers

What is included in the assessment of mental status?

Level of consciousness, alertness, and orientation (B) Signup and view all the answers

What can cause a dull note in lung percussion?

Atelectasis, pneumonia, or tumor (B) Signup and view all the answers

What is the term for a lower-pitched, booming sound found in lung percussion?

Hyperresonance (A) Signup and view all the answers

What is an indication of underlying disease in lung percussion?

Asymmetry in lung sounds with prominent dullness or marked hyperresonance (C) Signup and view all the answers

What is the purpose of auscultating lung sounds in Nursing Anne?

To practice auscultation of lung sounds (D) Signup and view all the answers

What is the appropriate nursing action for abnormal findings in the lungs and thorax exam?

Documenting and reporting the findings to the healthcare team (C) Signup and view all the answers

Study Notes

Assessment of Lungs and Thorax

Pattern: Important to ensure coverage of all lung fields and to listen to the lateral portion of the lungs (side of body)

Expected Lung Sounds

Clear lung sounds: Expected normal sound
No adventitious lung sounds: No crackles or wheezing
Bronchovesicular sound: Louder than vesicular, heard closest to bronchi, even on inspiration and expiration
Vesicular sound: Whisper-like sound, louder on inspiration, smaller airway

Adventitious Sounds

Fine crackles: High-pitched crackling
Coarse crackles: Fluid in the lungs, sounds like drinking a drink and reaching the bottom
Pleural friction fremitus: Friction in pleural tissue due to inflammation
Wheeze-sibilant: Obstruction, air escaping through small airway, narrowed
Wheeze-sonorous rhonchi: Obstruction, air escaping through small airway, narrowed on exhale
Stridor: Upper airway obstruction, something lodged in throat, common in children

Respiratory Rate, Rhythm, and Pulse Oximetry

Respiratory rate and rhythm: Regular, even, effortless, symmetric, consistent, 12-20 breaths per minute
Pulse oximetry: Noninvasive method to assess arterial oxygen saturation (SPO2), normal values: 97%-99%

Inspection

Respiratory rate and rhythm: 12-20, consistent, even, regular
Chest rise and fall: Symmetrical, no accessory muscle use or retractions
Comfortable positioning: No tripod position, no cyanosis
Chest wall configuration: Normal: AP:T is 1:2, abnormal: AP:T 1:1, barrel chest, irreversible
Nails: Abnormal: clubbing caused by chronic hypoxia
Posterior thorax: Abnormal: asymmetry and dorsal curvature, scoliosis, kyphosis, gibbus

Palpation

What to feel for: Abnormal findings: crepitus, friction, masses, temperature, normal findings: warm, no masses or tenderness
Technique: Hands move with breathing starting at T9 vertebrae, go from left to right to down and then right to left motions
Tactile Fremitus: palpable vibration, sounds generated from larynx, symmetric

Percussion

Client position: Slightly bent forward
Compare bilaterally: Note any symmetry, avoid body prominences
Specific technique: Start at apices and go side-to-side, working way down
Findings: Normal: resonance (low-pitch, clear, and hollow sound), abnormal: dull, can indicate fluid in lungs, pneumonia, or tumor

Auscultation

Position: Sit upright, relaxed, hands on knees
How to breathe: In and out of mouth every time stethoscope makes contact with skin
How far down to listen: To lateral part of back
Place on foot (for babies), finger, or toe: Inaccurate readings can be caused by carbon monoxide binding to Hgb instead of oxygen or anemia

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Description

A quiz about normal lung sounds and the pattern to listen to them, including bronchial and bronchovesicular sounds.