Reviewing what you know and thinking about each response choice can help you focus in on the correct answer. During lung auscultation, crackles are heard in pulmonary fibrosis, which is choice B. There would be loss of breath sounds over the area of a pneumothorax as there is no air movement in the area of auscultation. In general, there are not specific adventitious breath sounds associated with neuromuscular disorders.Ī pneumothorax is a collapsed lung. Diaphragmatic weakness can lead to hypoventilation chest wall muscle weakness can lead to ineffective cough and upper airway muscle weakness can lead to difficult swallowing and ineffective clearing of upper airway secretions. Neuromuscular disorders can cause respiratory problems through several pathways as the muscles responsible for breathing are affected. The crackles are the result of the snapping open of collapsed, stiff alveoli. This may be hard to distinguish from congestive heart failure. The most common adventitious breath sound associated with pulmonary fibrosis is fine bibasilar crackles. This scarring leads to thickness and stiffness in the lungs. Pulmonary fibrosis is a form of interstitial lung disease in which scarring (or fibrosis) is the hallmark clinical feature. For testing purposes, however, expiratory wheezes are associated with asthma. Initially the wheezes are expiratory but depending on confounding factors or worsening clinical symptoms, there may be inspiratory wheezes, rhonchi or crackles. As air moves through these narrowed airways, the primary lung sound is high-pitched wheeze.

This response is triggered by an irritant, allergen, or infection. The resulting physiologic response in the airways is bronchoconstriction and airway edema. AsthmaĪsthma is a condition mediated by inflammation.

In this instance, it would be helpful to go through each clinical condition separately and predict what you may hear on auscultation. Now, let’s think about test-taking strategies. Facing Ethical Challenges with Strength and Compassion.Establishing Yourself as a Professional and Developing Leadership Skills.

Ensuring Patient & Family Centered Care.Developing Critical Thinking Skills and Fostering Clinical Judgement.Alteplase Injection for Acute Ischemic Events.Affirming Care for Patients who are LGBTQ+.Lippincott Clinical Conferences On Demand.Continuing Education Bundle for Nurse Educators.Lippincott NursingCenter’s Critical Care Insider.Lippincott NursingCenter’s Career Advisor.Academic/Practice Innovation: An Interview with Dr.Becoming Great in Healthcare: Webinar Highlights.People Connections and Building Relationships: An Interview with Cathleen Wheatley.Teamwork is the Bedrock of a High Trust Culture.Connecting as an Organization Post-COVID.Supporting Staff Through Patient-Centered Innovation.This documentation indicates that the expected sound (vesicular) was heard, specifies where it was heard (majority of the lung fields), notes the absence of any additional (adventitious) sounds, and explicitly mentions some of the specific sounds you listened for but did not hear (wheezing, crackles, rhonchi, stridor). No wheezing, crackles, rhonchi, or stridor.” “Normal vesicular breath sounds heard over the majority of the lung fields. This means that you heard the expected breath sounds and there were no abnormal or extra sounds. If lung sounds are normal, they’re often described as “clear to auscultation bilaterally” or “CTAB” (an abbreviation of the same phrase). When charting normal lung sounds, it’s important to be concise, clear, and descriptive. Vesicular lung sounds: over most lung spacesĬharting normal lung sounds: how to document lung sounds.Bronchovesicular lung sounds: in the posterior chest between the scapulae and in the center of the anterior chest.Bronchial lung sounds: over the large airways in the anterior chest near the second and third intercostal spaces.The different types of lung sounds can be heard best in the following locations: Vesicular lung sounds: soft, blowing, or rustling.Bronchovesicular lung sounds: softer than bronchial sounds with a tubular quality.Tracheal lung sounds: harsh, like air in a pipe.Bronchial lung sounds: loud and high-pitched.Students: Educators’ Pro Tips for Tough Topics.Maternity Nursing and Care of the Childbearing Family.Diversity, Equity, Inclusion, and Belonging.

Rhonchi lung sounds means