NUR 325 Respiratory Review Question/ NUR325 Respiratory Review Question A GRADE

4/15/2018 Respiratory | Completed | Shadow Health Student Response: Adventitious lung sounds are abnormal, additional lung sounds, wheezes, crackles, rhonchi, stridor and pleural friction rub. There are two different types of crackles: coarse crackles and faint crackles. Coarse Crackles are usually heard in the upper airways. They are low-pitched and sound wet, with Jenson (2015) describing the sound as being similar to when you seperate velcro. Fine crackles, on the other hand, are high-pitched, crackling sound, usually heard in the lower lung fields. Jenson, (2015) describes the sound like what rubbing hair between your fingers sounds like. References Jensen, S. (2015). Nursing health assessment: A best practice approach (2nd ed.). Philadelphia: Lippincott Williams & Wilkins. Model Note: Wheezes are continuous, high-pitched musical sounds caused by the airway narrowing from swelling, secretions, or masses. Fine crackles are high-pitched popping sounds created when inhaled air meets deflated alveoli, causing them to pop open, usually found in the bases of the lower lobes. They sound like rolling a strand of hair between your thumb and index finger. Coarse crackles are loud, discontinuous, low-pitched bubbling sounds created by air meeting secretions in the large airways. They sound like separating a Velcro fastener. Rhonchi are continuous, low-pitched snoring sounds caused by airway obstruction from secretions, muscular constriction, or masses. Pleural rub is a discontinuous, low-pitched grating sound created from pleura rubbing together. Tina has a history of asthma. What sounds might you hear during an asthma exacerbation? Student Response: "Asthma is a chronic inflammatory disorder of the bronchial mucosa that causes bronchial hyperresponsiveness, constriction of the airways, and variable airflow obstruction that is reversible” (McCance & Huether, 2014, p.1263). Typically, asthma is categorized as having a sensitive, overlyresponsive airway, with a fluctuating restriction of airflow (Himes, & Weitzman, 2016). Because the airway can become narrow during an asthma exacerbation, wheezes can often be heard. Wheezes are usually heard on expiration in asthma, but sometimes they can be heard during inspiration as well. In some cases, if the the asthma exacerbation is severe, stridor will be heard. Stridor is high pitched whistle or honking sounds often heard without a stethoscope. It occurs when the upper airway becomes inflamed or spasms, and needs immediate attention. References Himes, B.E., & Weitzman, E.R. (2016). Innovations in health information technologies for chronic pulmonary diseases. Respiratory Research, 171-7. doi:10.1186/s McCance, K., Huether, S. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children, 7th Edition. Model Note: During an asthma exacerbation, bilateral wheezing would be heard predominantly, especially on expiration. Wheezing is sometimes accompanied by decreased breath sounds. This study resource was shared via CourseH