Assessment by Ausculation
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| Assessment By Auscultation Normal Breath Sounds: Vesicular | normal breath sounds = vesicular
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| Assessment By Auscultation Normal Breath Sounds: Bilateral Vesicular | normal sounds in both lungs
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| Assessment By Auscultation Normal Breath Sounds: Bronchial | normal sounds heard over the trachea or bronchi.
the sounds heard over lung periphery = lung consolidation
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| Assessment By Auscultation Changes | changes in the breath sounds will identify where the problem is.
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| Assessment By Auscultation Egophony | patient is told to say "E" sounds like "A" = Pneumonia
= lung consolidation
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| Assessment By Auscultation Bronchophony/Whispered Pectoriloquy | increased intensity of spoke voice
= pneumonia and consolidation
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| Assessment By Auscultation Increased/Decreased | any increase in the spoken voice indicates pneumonia
any decrease obstructed bronchi pneumothorax, emphysema
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| Assessment By Auscultation Abnormal Breath Sounds/Adventitious/Rales | rales/ crackles = secretion/ fluid
coarse rales (rhonchi) = large airway secretions
Tx: patient needs suctioning
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| Assessment By Auscultation Abnormal Breath Sounds/Adventitious/ Medium Rales | medium rales = middle airway secretions
Tx: patient need chest physical therapy
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| Assessment By Auscultation Abnormal Breath Sounds/Adventitious/ Fine Rales | fine rales = (moist crepitant rales) = alveoli, fluid
patient has CHF/ pulmonary edema
Tx: IPPB, heart drugs, diuretics, and oxygen
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| Assessment By Auscultation Abnormal Breath Sounds/Adventitious/ Wheeze | due to bronchospasm
Tx: bronchodilator
unilateral wheeze = foreign body obstruction
Tx: bronchoscope
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| Assessment By Auscultation Abnormal Breath Sounds/Adventitious/ Stridor | due to upper airway obstruction
supraglottic = (epiglottis)
subglottic = (croup, post extubation)
foreign body aspiration (solids or fluids)
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| Assessment By Auscultation Abnormal Breath Sounds/Adventitious/ Stridor Treatment | topical decongestant (racemic epinephrine) for swelling/edema
suction/bronchoscope for secretions/foreign body
intubate for SEVERE swelling and epiglottis
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| Assessment By Auscultation Abnormal Breath Sounds/Adventitious/ Pleural Friction Rub | coarse or crunching sound
caused by inflamed surface of visceral & parietal rubbing
Association: TB, pneumonia, pulmonary infarction, cancer
Tx: steroids and antibiotics
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| Assessment By Auscultation Heart Sounds/Normal/S1 | sounds made by the closure of the heart valves
first sound S1= mitral and tricuspid valve at beginning of ventricular contraction
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| Assessment By Auscultation Heart Sounds/Normal/S2 | second sound S2
occurs when systole ends.
the ventricles relax the pulmonic and aortic valves close.
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| Assessment By Auscultation Heart Sounds/Abnormal/S3 | if you hear S3 in adults = abnormal = suggest CHF
= myocardial infarction or cardiomegaly
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| Assessment By Auscultation Heart Sounds/Abnormal/S3 &S4 | are low pitched may be difficult to discriminate
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| Assessment By Auscultation Heart Sounds/Abnormal/Heart Murmurs | caused by turbulent blood flow.
heart valve defect
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| Assessment By Auscultation Heart Sounds/Abnormal/Heart Murmurs Occurs | murmurs occur when blood is pushed through an abnormal opening such as an atrial septal defect.
or patent ductus arteriosus.
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| Assessment By Auscultation Heart Sounds/Abnormal/Heart Bruits | are the sounds made in an artery or vein
that moves at an abnormal speed.
heard over stethoscope over the identified vessel
carotid
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| Assessment By Auscultation Blood Pressure measured | measure the systolic and diastolic pressures.
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| Assessment By Auscultation Blood Pressure | use a sphygmomanometer to measure cuff pressure.
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| Assessment By Auscultation Blood Pressure/Normal | Adult: 120/80
acceptable: 90/60 to
140/90
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| Assessment By Auscultation Blood Pressure/Increased | hypertension = indicates stress = hypoxemia
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| Assessment By Auscultation Blood Pressure/Decreased | hypotension = indicates poor perfusion = hypovolemia, CHF
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