Respiratory System and Lung Sounds
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Questions and Answers

What is the normal respiratory rate?

  • 12-20 (correct)
  • 10-15
  • 20-25
  • 15-30

    • What is the term for the muscles used in labored breathing other than the diaphragm and intercostal muscles?

  • Intercostal muscles
  • Secondary muscles
  • Accessory muscles (correct)
  • Respiratory muscles

    • What does a barrel chest configuration indicate?

  • Pneumonia
  • Pleural effusion
  • Asthma
  • COPD (correct)

    • What is the term for the abnormal curvature of the dorsal spine?

    <p>All of the above</p> Signup and view all the answers

    What is the primary reason for using a pattern when listening to lung fields?

    <p>To ensure you cover all lung fields</p> Signup and view all the answers

    What is the normal AP:T ratio in a healthy individual?

    <p>1:2</p> Signup and view all the answers

    What is a normal finding during inspection of the lungs?

    <p>Warmth and no tenderness</p> Signup and view all the answers

    What is the characteristic of a bronchial sound?

    <p>Loud, high-pitched, and heard over the trachea</p> Signup and view all the answers

    What is the direction of hand movement during lung inspection?

    <p>From left to right and then down</p> Signup and view all the answers

    What is the term for the bluish discoloration of the skin and mucous membranes?

    <p>Cyanosis</p> Signup and view all the answers

    What is the characteristic of a vesicular sound?

    <p>Whisper-like, and heard over the lateral part of the body</p> Signup and view all the answers

    What is the purpose of placing the hands in a W shape on the mid-back during inspection?

    <p>To check for symmetric chest expansion</p> Signup and view all the answers

    What is the term for the abnormal nail shape caused by chronic hypoxia?

    <p>Clubbing</p> Signup and view all the answers

    What does the presence of coarse crackles in the lungs indicate?

    <p>Fluid in the lungs</p> Signup and view all the answers

    What is the typical positioning of an individual with COPD?

    <p>Tripod position</p> Signup and view all the answers

    What is the primary purpose of pulse oximetry?

    <p>To assess arterial oxygen saturation</p> Signup and view all the answers

    What is palpable vibration during tactile fremitus?

    <p>A palpable vibration generated from the larynx</p> Signup and view all the answers

    What should the patient do during the tactile fremitus assessment?

    <p>Say '99, 99' and 'blue moon'</p> Signup and view all the answers

    What is the normal range for respiratory rate in breaths per minute?

    <p>12-20 breaths per minute</p> Signup and view all the answers

    What is the normal finding during percussion of the lungs?

    <p>Resonance</p> Signup and view all the answers

    What is the characteristic of a bronchovesicular sound?

    <p>Even on inspiration and expiration, and heard closest to bronchi</p> Signup and view all the answers

    What is the primary purpose of assessing respiratory rate and rhythm?

    <p>To evaluate the overall health of the lungs</p> Signup and view all the answers

    Why do we hear different sounds over bones than over lung tissue during percussion?

    <p>Because bones are denser</p> Signup and view all the answers

    How should the patient breathe during auscultation?

    <p>Breathe in and out of the mouth each time the stethoscope contacts the skin</p> Signup and view all the answers

    What is the primary purpose of percussion of the lungs?

    <p>To aid in determining if lung tissue is healthy in an adult</p> Signup and view all the answers

    During percussion of the lungs, what should the practitioner avoid?

    <p>Percussing over the scapula and ribs</p> Signup and view all the answers

    What is a characteristic of resonance in healthy lung tissues?

    <p>Low-pitched, clear, hollow sound</p> Signup and view all the answers

    What does hyperresonance in lung percussion indicate?

    <p>Too much air present in lungs</p> Signup and view all the answers

    What is a characteristic of abnormal findings in lung percussion?

    <p>Asymmetry with prominent dullness or marked hyperresonance</p> Signup and view all the answers

    What is a common complication of carbon monoxide binding to hemoglobin?

    <p>Inaccurate readings</p> Signup and view all the answers

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

    <p>To evaluate respiratory function</p> Signup and view all the answers

    What should the nurse do in response to abnormal findings in the lungs and thorax exam?

    <p>Document the findings and initiate appropriate nursing actions</p> Signup and view all the answers

    What is one of the major functions of respiration?

    <p>Maintaining homeostasis</p> Signup and view all the answers

    What does the 'B' in 'ABC' stand for in a medical context?

    <p>Breathing</p> Signup and view all the answers

    When should a patient's lungs be assessed?

    <p>Every shift, with every patient</p> Signup and view all the answers

    What is the main purpose of using the Glasgow Coma Scale (GCS)?

    <p>To measure a patient's level of consciousness</p> Signup and view all the answers

    What is the optimal position for assessing a patient's lungs?

    <p>Sitting in a relaxed position with shoulders drooping and slightly forward</p> Signup and view all the answers

    What is the scoring range for the Glasgow Coma Scale (GCS)?

    <p>3-15</p> Signup and view all the answers

    Which of the following is NOT a component of a neurological examination?

    <p>Blood pressure</p> Signup and view all the answers

    What is the purpose of assessing a patient's LOC (Level of Consciousness)?

    <p>To assess a patient's mental status</p> Signup and view all the answers

    Study Notes

    Assessment of Lungs and Thorax

    • Pattern is important to ensure coverage of all lung fields and listening to the lateral portion of the lungs (side of body).
    • Expected normal findings:
      • Clear lung sounds
      • No adventitious lung sounds (crackles or wheezing)
      • Bronchovesicular sounds over major bronchi
      • Vesicular sounds over peripheral lung fields

    Bronchial Sound

    • Heard on anterior chest over trachea
    • Characterized as loud, high-pitched

    Bronchovesicular Sound

    • Heard closest to bronchi
    • Louder than vesicular sounds
    • Even on inspiration and expiration

    Vesicular Sound

    • Heard on lateral part of body
    • Whisper-like sound
    • Louder on inspiration
    • Associated with smaller airways

    Adventitious Sounds

    • Examples:
      • Fine crackles (high-pitched crackling)
      • Coarse crackles (fluid in lungs, sounds like drinking through a straw)
      • 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)

    Assessment of Respiratory Rate, Rhythm, and Pulse Oximetry

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

    Inspection

    • Respiratory rate and rhythm:
      • Rate: 12-20 breaths per minute
      • Rhythm: consistent, even, regular
    • Chest rise and fall symmetrical
    • No accessory muscle use or retractions
    • Comfortable positioning, not in tripod position
    • Color appropriate for ethnicity, no cyanosis
    • Chest wall configuration:
      • Normal: AP:T is 1:2
      • Abnormal: AP:T 1:1, barrel chest, irreversible (e.g., COPD)
    • Nails:
      • Abnormal: Clubbing caused by chronic hypoxia
    • Posterior thorax:
      • Abnormal: Asymmetry and dorsal curvature (e.g., scoliosis, kyphosis)

    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
      • Technique: use palmar base of fingers

    Percussion

    • Client position:
      • Slightly bent forward
    • Compare bilaterally and note any symmetry
    • Avoid body prominences
    • Specific technique:
      • Starting at apices and going 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
    • Pattern:
      • Why do we hear different sounds over bones than over lung tissue?
        • Bones are denser, giving a dull flat sound
      • Compare bilaterally

    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
      • Anemia

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    Description

    This quiz covers the importance of pattern in listening to lung sounds, what to expect to hear, and the characteristics of bronchial and bronchovesicular sounds in the respiratory system.

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