Chest assessment help... Please!

Here are a couple links that I really like that may help you : )

http://www.rale.ca/

http://www.med.ucla.edu/wilkes/credits.htm

Good luck : )

Hi everyone, how your week going?

I have a mean clinical instructor who is evaluating my chest assessment next week. I learned it 1st semester but for some reason I'm totally freaking out about this e-val with her. I never finish my paperwork on time, therefor I get a "U" on my tools. If I don't improve I fail the semester.

Basically I have difficulty auscultating one breath sound from another. I understand vesicular is nl, but so is tracheal and bronchial. So which one should I write down? If I place my scope in all areas like I'm supposed to, wouldn't I hear all three sounds if my pt. were nl? I don't get why it's one or the other.

And if they have adventitous BS, determining if they're gurgles or rales is hard for me. They sound similar. What I hear isn't what other students hear and that makes me second guess myself from the beginning.

Also the percussion has always thrown me, even with abdominal assmnts. Honestly I don't get much from that part of the assessment. The 3 remaining parts (IPA) are what help me assess. I tap on my clavacle and do not hear "resonance" I hear a thump. No matter where I percuss I hear the same thing.

I'm sure I sound like a total retard to you guys because I should know such an easy form of assessment, being the basics. But being my 3rd semester and graduating next May, I'm so scared I'm not going to do well enough for my clinical instructors to pass me. My paperwork is aweful! It takes me forever to complete thanks to the Excel unit care plan format.

I'm perfectly fine when I'm at work or no where near my instructors. They make me so nervous and they like it. Please send me a private message (PM) if anyone has some time to guide me in the right direction.

Take care! :rotfl:

Here are a couple links that I really like that may help you : )

http://www.rale.ca/

http://www.med.ucla.edu/wilkes/credits.htm

Good luck : )

Thank you so much. If you have any others, let me know. I search for hours for helpful sites that posters save.

Rales always sounded to me like aluminium foil being crinkled up. By far, the most adventitious sounds I've heard were rales. I recognized gurgles the first time I heard them. They sounded to me like someone blowing air through a straw in a glass of water--that bubbly sound.

I remember checking to see if the patien'ts gown was brushing against my stethoscope the first time I heard rales

Personally, I don't think all the tapes and videos in the world prepare you as much as actually *hearing* them for yourself..

I know the original post is older, but the response may help someone else. Well, let me first start by saying your instructors are jerks. I so remember those days and it infuriates me to know that instructors get joy out of intimidating students or playing god with a students future in any profession. I hope to be 'the Director' one day, versus an instructor because I will refuse to allow it. Now as far as auscluatations, I don't care what any instructor tells you, it just takes practice listening to decipher the different sounds, even then you find that nurses and even respiratory therpist that have many years of experience will disagree on what they hear. There are videos out there that would help you, even YouTube videos, so try that. Hand tough