Abnormal lung sound

Posted
by Alt0712 (New) New

I'm hoping someone can help me. I am a new LPN assessing the lung sounds of my patient. 12yrs old cerebral palsy but no current respiratory problems, has chest vest twice day therapy done and aside from the occasional rhonchi that is cleared when he coughs he is normally clear. No URI currently or sicknesses. Today when I auscultated his lung sounds I immmediatley heard bubbling sounds so you would assume crackles but he wasn't breathing at the time...sometimes he just takes a sec or two for him to take another good breath, no respiratory distress at all. O2 100% and HR 80 RR 12...any suggestions? HR rhythm normal no s/s of pericardial rub.

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 12 years experience. 1 Article; 13,949 Posts

Are you certain it wasn't resonance of pooled oral secretions? I've had several (boys more commonly) essentially gargling saliva and depending on size you can hear it in the lungs. It can also happen with tracheal secretions not yet cleardd

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 16 years experience. 224 Articles; 27,608 Posts

Thread has been moved to the LPN/LVN Corner forum.

Alt0712

4 Posts

I guess that could be an option. He didn't sound "junky" like in his throat like he does sometimes but that doesn't really mean that that isn't what I was hearing because if this makes any sense I can still hear clear airflow, the hollow sound that they talk about..I just needed some other ideas of what I could be hearing. I didn't think it was a respiratory concern mainly because all of his vitals were great and no extra effort to breathe....I have noticed a similar sound to this before with him but normally he is extra junky that day and coughing a bunch of phlegm up too so I didn't even think about it today...thanks for your input!

Cactus Nurse

Specializes in TBI and SCI. 165 Posts

I had a similar pt, a bit younger tho, 6 y/o. My pt had recurring pneumonia. He sounded wheezy one morning I left, had a low grade fever that was slowly starting, then he got a high heart rate. The mom took him to the doctor a few hours after I had left, and he had pneumonia. I guess you can be on the lookout for that. I really struggled in the beginning with my pt because he always "breathed weird" bad terms I know. But it was strange and then after I suctioned him the first time, I realized what his clear trachea sounded like. It's kinda tough. youre doing great. Great assessment :up:

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 12 years experience. 1 Article; 13,949 Posts

Kids are good until they are not. I've sent many children compensate and play and then the illness hits them. Pneumonia can gurgle.

My son is great and "normal" from 101.8-103F you wouldn't even think to take his temp. 99.9-100.2 you'd think my son was dying of some plague or sepsis. Once creeps past 103 lethargy sets in and he's a wet noodle. He's had a high WBC count and "weird" breath sounds. Give him an albuterol and it all breaks loose.

Don't assume a URI or other infection isn't brewing