Hi, I am a new nurse. During last night's shift (I work nights), I auscultated fine inspiratory crackles in my pt's lungs in their bilateral lower lobes. My pt was there for something totally unrelated-colitis, and has no heart/lung history besides HTN. She was gettting fluids at 100 mL/hr. Her vitals were stable and she wasn't short of breath. My charge nurse also heard them (I asked her to verify) and then a few hours later I checked again and they were still there. I asked my charge nurse if this is something concerning, and she said since the patient's vitals were stable, she wasn't SOB, and as long as the crackles didn't "increase" over night, it's okay and I can pass it on in report and possibly the next nurse can tell the rounding MD who could possibly decrease fluids. Also the crackles didn't clear when I asked her to cough.
So I am wondering, were the crackles concerning? They were a new finding but I'm not sure physiologically how that could have happened besides the pt maybe being fluid overloaded. I guess I'm just confused about why my charge nurse was not that concerned. Maybe I should've text paged the MD to possibly turn down the fluid rate? Can I just say that it is challenging as a new nurse that so many things are gray, and it's hard to transfer what I learned in school to real life.