Nursing 105

Essentials of Nursing Study Guide

©2018 Achieve Page 67 of 160 sounds: abnormal breath sounds occurring when air passes through narrowed airways or airways filled with fluid or mucus; also occurs when pleural linings are inflamed • Bronchial breath sounds : high pitched, blowing, muffled, expiratory sounds slightly longer than inspiratory sound • Bronchovesicular breath sounds : louder and harsher than vesicular sounds; muffled vesicular sound combined with loud guttural sound; equal on inspiration and expiration • Vesicular breath sounds: soft and low-pitched; rustling or breezy; three times longer on inspiration than expiration • Tracheal breath sounds: high pitched, loud, harsh, hollow sounding; equal on inspiration and expiration • Fine crackles (Rales:) typically a popping sound; they may sound like slurping through a straw in patients with pulmonary edema • Coarse crackles (Rhonchi): bubbling or gurgling; usually clear or decreased after coughing • Friction Rub: a superficial grating or creaking and are not relieved by coughing • Sibilant wheezes: high pitched musical or whistling sounds, usually heard during or at the end of expiration • Sonorous wheezes: deep, low-pitched rumbling sounds, usually heard during expiration Nursing Procedures History/Health Assessment: check for current respiratory problems, history of respiratory problems, current or past cardiovascular problems, lifestyle, presence of cough, description of sputum, presence of chest pain, medical history, risk factors, or changes in the respiratory system which can be chronic or acute • COPD (chronic bronchitis, emphysema, asthma) is a chronic health problem; patients with chronic respiratory problems tend to bend forward or prop their arms on a support to elevate the clavicles to expand the chest fully in an effort to breatheeasier. • Atelectasis is an acute respiratoryproblem. 3.2 Oxygenation Factors Influencing Patient’s Oxygenation • Environmental factors : The higher the altitude, the lower the partial pressure (PO2) of oxygen. Air pollution (smog) causes altered respiratory function. Room ventilation, overcrowded conditions, and humidity all will affect respiratory function. Occupation fumes (pollutants in the work place), sand (silicosis), coal (anthracosis), asbestos (asbestosis), and working with birds (sarcoidosis) can also affect a patient’soxygenation. Lung Sounds • Adventitious breath