Transcript Abnormal Lung Sounds

Lung Sounds
Melissa Lewis, RN
Allied Health Sciences I
4th Block
Respiratory Movements
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1 inspiration + 1 expiration = 1 respiration
Normal adult = 14 – 20 respirations per minute
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Increases with exercise, body temperature, certain
diseases
Decreases with sleep ***
Emotions can increase or decrease rate
Normal newborn rate = 40 – 60 respirations
per minute
Respiratory Movements
cont…
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Coughing: deep breath followed by forceful
expulsion of air to clear lower respiratory tract
Hiccups: Spasm of diaphragm
Sneezing: Air forced through nose to clear
respiratory tract
Yawning: Deep prolonged breath that fills the
lungs, increases oxygen within the blood
Patient Assessment
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Listening to a patient’s lung sounds
(breath sounds) is extremely
important
You can hear someone breathe with
your ears, especially if it is not normal
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a stethoscope (auscultation)
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How do you listen to breath
sounds accurately?
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Make the environment as quiet as possible
The patient should be sitting up if possible and
comfortable
The patient will breathe in and out through their
mouth
The stethoscope’s diaphragm should be warmed with
the hands before placing on patient
It is best to listen to the lung sounds with the
stethoscope placed directly on the skin (if not
possible you can hear through thin clothing)
How do you listen to breath
sounds accurately?
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Listen to the lungs symmetrically (listen
in one area on the right and then listen to
the same area on the left, etc)
Remember…the lungs are as high as your
collar bones and as low as your
diaphragm (anterior and posterior)
Listen from top to bottom
Describe what you hear (rate, rhythm,
etc.)
How should lungs sound
normally?
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The sound changes as you go from upper
to lower because the airways go from big
to small
The main objective is to make sure that
the right and the left sound the same
If there is a change from one side to
another there is probably a problem
Abnormal Lung Sounds
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Abnormal lung sounds are caused by
obstruction, narrowed airways, fluid, etc.
These abnormal sounds could sound like
bubbles, crackles, or rubbing
Lots of different diseases/illnesses that
can cause abnormal lung sounds
temporarily or permanently
Respiratory
Disorders
Common Cold
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Contagious viral respiratory infection
Indirect causes: chilling, fatigue, lack of
proper diet, and not enough sleep
Rx = stay in bed (rest), drink warm liquids
Also called an upper respiratory infection
(URI)
Handwashing = best preventative measure
Laryngitis
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Inflammation of the larynx or voice box
Often secondary to other respiratory
infections
Symptoms = sore throat, hoarseness or
loss of voice, dysphagia (difficulty
swallowing)
Sinusitis
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Infection of the mucous membrane that lines
the sinus cavities
Caused by bacteria or viruses
Symptoms = headache or pressure, thick nasal
drainage, loss of voice resonance
Rx = symptomatic, surgery for chronic
sinusitis
Pharyngitis
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Red inflamed throat
Sore throat
Difficulty swallowing
Bronchitis
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Inflammation of the mucous membranes of the
trachea and bronchial tubes which produces
excessive mucous
Acute or chronic
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Acute bronchitis is characterized by cough, fever,
sub-sternal pain and rales (raspy sound)
Chronic bronchitis is caused mainly by
cigarette smoking***
Influenza
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Viral infection***
Symptoms = fever, nasal discharge, muscular
pain, extreme exhaustion
Complications = pneumonia, neuritis, otitis
media (ear infection), and pleurisy
Rx = treat symptoms (rest, fluids, etc)
Pneumonia
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Infection of the lung
Bacterial or viral
Alveoli fill with thick fluid
Symptoms = chest pain, fever, chills, dyspnea
Rx = give oxygen and antibiotics if bacterial
Tuberculosis
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Infectious bacterial lung disease
Tubercles (lesions) form in lungs
Symptoms = cough, low-grade fever in afternoon,
weight loss, night sweats
Diagnosis = TB skin test
If skin test positive – follow up with chest x-ray and
sputum sample
Rx = antibiotic
(HC providers worry about foreigners bringing this
into the United States)
Asthma
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Inflammatory airway obstruction
Caused by allergen or psychological stress
5% of Americans have asthma
Symptoms = Difficutly exhaling, dyspnea,
wheezing, tightness in chest
Rx = anti-inflammatory drugs, inhaled
bronchodilator
Emphysema
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Alveoli become over-dilated, lose their elasticity,
cannot rebound, may eventually rupture
Air becomes trapped, cannot exhale – forced
exhalation required
Reduced exhange of oxygen and carbon dioxide
Dyspnea increases as disease progresses
Rx = alleviate symptoms, decrease exposure to
respiratory irritants, prevent infections, restructure
activities to prevent need for oxygen
THE END!