1. Melissa Lewis, RN Allied Health Sciences I 4th Block
Lung Sounds
Melissa Lewis, RN
Allied Health Sciences I
4th Block

2. Respiratory Movements
1 inspiration + 1 expiration = 1 respiration
Normal adult = 14 – 20 respirations per minute
Increases with exercise, body temperature, certain diseases
Decreases with sleep ***
Emotions can increase or decrease rate
Normal newborn rate = 40 – 60 respirations per minute

3. Respiratory Movements cont…
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

4. Patient Assessment
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
However, the best way is to listen with a stethoscope (auscultation)

5. How do you listen to breath sounds accurately?
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)

6. How do you listen to breath sounds accurately?
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.)

7. How should lungs sound normally?
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

8. Abnormal Lung Sounds
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

9. Respiratory Disorders

10. Common Cold 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

11. Laryngitis Inflammation of the larynx or voice box
Often secondary to other respiratory infections
Symptoms = sore throat, hoarseness or loss of voice, dysphagia (difficulty swallowing)

12. Sinusitis
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

13. Pharyngitis
Red inflamed throat
Sore throat
Difficulty swallowing

14. Bronchitis
Inflammation of the mucous membranes of the trachea and bronchial tubes which produces excessive mucous
Acute or chronic
Acute bronchitis is characterized by cough, fever, sub-sternal pain and rales (raspy sound)
Chronic bronchitis is caused mainly by cigarette smoking***

15. Influenza 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)

16. Pneumonia 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

17. Tuberculosis 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)

18. Asthma 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

19. Emphysema
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

20. THE END!