![]() Low-pitched wheezing (rhonchi) may indicate pneumonia. Wheezing may indicate asthma, bronchitis, or emphysema. Vesicular breath sounds are heard over most of the peripheral lung fields bronchovesicular sounds are heard over main bronchi tracheal and bronchial sounds are heard over trachea.įine crackles (rales) may indicate asthma and chronic obstructive pulmonary disease (COPD).Ĭoarse crackles may indicate pulmonary edema. Normal breath sounds include tracheal, bronchial, bronchovesicular, and vesicular.Listen to at least one full breath (inspiration and expiration) at each spot.Use a systematic pattern to auscultate anterior, lateral, and posterior chest walls (see illustration below).Place the diaphragm side of the stethoscope against the skin to listen to breath sounds.Instruct the patient to take deep breaths through the mouth during auscultation.Auscultate lungs for breath sounds and adventitious sounds. With hypoxemia, cyanosis of the extremities or around the mouth may be noted.ģ. Ratio of AP to Lateral diameterĪsymmetrical chest expansion may indicate conditions such as pneumothorax, rib fracture, severe pneumonia, or atelectasis. The anteroposterior (AP) diameter of the thorax should be approximately 1/2 of the lateral diameter. Patients in respiratory distress may have an anxious expression, pursed lips, and/or nasal flaring. Chandrasekhar, Loyola University Medical Education Network. Copyrighted materials used with permission of the author, A. Note: Click the hyperlink to access more details. Skin color of lips, face, hands ( clubbing fingers).Respirations for rate (1 minute), depth, rhythm pattern.Shape and symmetry of the chest, anteroposterior to lateral diameter.Lifting the sides of the nostrils could indicate excessive breathing effort. Accessory muscles include scalenes, sternocleidomastoid muscle, and intercostal muscles. Use of accessory breathing muscles while at rest is a sign of respiratory distress.Use of accessory muscles and work of breathing.Conduct a focused interview related to history of respiratory disease, smoking, and environmental exposures.Īsk relevant questions related to dyspnea, cough/sputum, fever, chills, chest pain with breathing, previous history, treatment, medications, etc. ![]() Apply principles of asepsis and safety.ġ. ![]()
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