Lung Sounds: Diminished or Shallow?

Can someone explain to me what diminished lungs are and what is the significance of this?? Everyone I ask either doesn't know or they just say it means you don't hear the usual clear swooshing in and out (probably not a good way to put it).

Great Video on Lung Sounds 

 

[UM Review RN, ASN, RN]

paga said:

I'm a new grad RN from Ca. It's my first job as a nurse, a client becomes lethargic, restless, 02 sat shows 87%, but V/S normal. I charted diminished lung sounds and requested CXR to be done. How do I really hear a diminished lung sounds, he's on dialysis and has a non healing wound at the back. maybe because he's in too much pain or just tired of the dialysis, or there is impending S/S of pneumonia or atelactasis whatever.

If his O2 sat is 87%, his vitals are not quite normal. I hope you started O2 @ 2L. Doesn't matter whether you hear anything or not; I've seen people with big trouble come up clear on X-rays, most notably CHF.

And the first couple of signs for CHF in a patient are c/o dyspnea with diminished breath sounds, THEN you start to hear the crackles.

[Blackcat99]

PennyLane said:

Here's a related question, since I don't have much experience to gauge this against: yesterday I had an obese female patient and her lungs sounds were diminished (to my ears). She was in quite a lot of pain, so she may not have been breathing very deeply. But I was wondering if it's 'normal' to hear diminished lung sounds in an obese person? My thinking is that there's so much tissue between your stethoscope and the lungs that the sound doesn't carry as well.

Yes it is normal to hear diminished lung sounds in an obese person.

[Thunderwolf, MSN, RN]

Was an ABG done or other labs? Was O2 given?

[JAAS]

Absent or decreased breath sounds can mean:

Air or fluid in the lungs: Such as pneumonia, pleural effusion, or heart failure

Thickened chest wall

Over-inflated lungs: Such as emphysema

Reduced airflow: Such as asthma flare-ups

Weak sound generation

Impaired transmission

Shallow breathing

Airway obstruction

Obesity

 

Occasionally, nurses document their assessment as decreased breath sounds. It is so vague. It doesn't say anything. You need to explain why there is a decrease in the breath sounds. It might be due to atelectasis, an emergency condition in which a physical exam may reveal decreased or absent breath sounds over the affected area.