Overview
This lecture covers lung auscultation, including techniques, normal and abnormal breath sounds, and key assessment tips for nursing students.
Auscultation Technique
- Auscultation is listening to lung sounds using a stethoscope between the ribs (intercostal spaces).
- Always use the diaphragm (large side) of the stethoscope for lung assessment.
- Begin at the apices (top of the lungs) and proceed in a side-to-side zigzag pattern.
- Have the patient breathe in and out with each placement to hear both inspiration and expiration.
- Place the stethoscope on bare skin to avoid extra noise from clothing or gowns.
- Assess both the front (anterior) and back (posterior) of the chest for a complete evaluation.
- For lateral (side) assessment, lift the patient's arm and place the stethoscope on the mid-axillary line.
Normal Breath Sounds
- Vesicular breath sounds are soft, low-pitched, and heard over most peripheral lung fields (alveoli).
- Bronchial sounds are loud and high-pitched, heard over the trachea.
- Bronchovesicular sounds are medium in pitch and intensity, heard over the sternum or near the sternum.
Assessment Tips
- Take your time to prevent the patient from hyperventilating.
- Ensure you hear both inhalation and exhalation before moving to the next spot.
- Side assessment is useful if the back cannot be accessed (e.g., spinal injury).
Practice Questions & Answers
- High, harsh sound over trachea with short inspiration and long expiration: Document as bronchial breath sounds.
- Most common sound over lungs: Vesicular breath sounds.
- Normal breath sounds: Soft, low-pitched, breezy vesicular sounds over peripheral lung fields.
Key Terms & Definitions
- Auscultation — Listening to internal body sounds, commonly using a stethoscope.
- Vesicular — Soft, breezy sounds heard over peripheral lung fields.
- Bronchial — Loud, harsh sounds over the trachea.
- Bronchovesicular — Medium intensity/pitch sounds near the sternum.
- Intercostal space — The space between two ribs.
- Diaphragm (stethoscope) — The flat, large side used for high-frequency sounds like lungs.
Action Items / Next Steps
- Practice auscultation technique on a partner or manikin.
- Review abnormal lung sounds in the referenced segment.
- Read about normal vs. abnormal breath sounds in your nursing textbook.