Lung sounds after lobectomy

[alynch08]

In the past I've taken care of patient's who have had lobectomy, and have still heard air exchange. If I didn't know their history, I wouldn't be able to tell a difference in their lung sounds. This has been more than one patient. What's up with that? I expected them to have absent lung sounds, and many of my co-workers would report "absent" lung sounds. Why am I hearing adequate exchange??

[SaoirseRN]

You will always hear breath sounds bilaterally even when a patient has had a lobectomy. Instead of charting "air entry", chart "breath sounds". It isn't wrong to say "breath sounds heard bilaterally" because it's the truth -- you did.

[Twinmom06, ASN, APN]

I'm tired and read this as "lobotomy" - and was thinking "why wouldn't she hear breath sounds after a lobotomy" LOL

[aachavez]

In clinical we had a patient with the same thing, and all us newbie student nurses are totally stumped! Thanks, now I know its not just me and I'm not losing my mind! lol

[KBICU]

Depending on the lobe removed sometimes fluid shifts and pushes the other parts up or down, causing lung sounds to be heard when you dont expect it. Asked this same question to a CV surgeon and thats what i got for a response :)

[Esme12, ASN, BSN, RN]

I am not so sure they are "normal" nad that they qualify as adequate exchange. But.....You will have some sort of breath sounds with just a lobectomy. Even with a pneumo they are really diminished but there is something.

[Stcroix, ASN, PhD, RN]

I was told by a pulmonologist that the lung is fairly elastic tissue. After a lobectomy, the remaining lung "stretches and re-positions itself somewhat" so that lung sounds may appear in the area where the lobe was removed. So in many cases, lung sounds can be heard in all fields.