Respiratory question

Ivanna_Nurse, BSN, RN · Feb 24, 2009

Hey there, I'll take a stab. Take a look at chest xrays, white cell counts, oxygenation needs, breath sounds, overall general state. ~Ivanna

Keysnurse2008 · Feb 24, 2009

With Atelectasis - you will hear diminished or no breath sounds when they inhale deeply. With pneumonia when they inhale deeply , listen carefully to the breath sounds . At the end of that inspiratory effort you can hear little " pops" from air trying to move through the thick sludge of pneumonia secretions. So .....hold the stethescope firmly against the skin and just listen. Also pay attention to the upper lobes, when they inhale do you hear fine whistling, expiratory wheezing etc etc . This can tell you how constricted those upper airways are. Hope this helps.....

leslie :-D · Feb 24, 2009

agree w/tnn...

that w/atelectasis, lung sound will be greatly diminished or absent...

except with rul, then you may hear transmitted tracheal sounds.

often, having pt deep breathe and cough will have collapsed lung return to baseline.

at that point, you will see o2 sat markedly increase.

with pneumonia, you'll hear crackles/rales.

even with breathing, coughing, o2 sat won't show a notable increase.

leslie

Daytonite, BSN, RN · Feb 24, 2009

Atelectasis

dry, nonproductive cough
rapid, shallow respirations
the trachea deviates toward the affected side (this is due to lung collapse on one side)
pleuritic chest pain
anxiety
cyanosis
diaphoresis
dullness to percussion
inspiratory lag
substernal or intercostal retractions
decreased vocal fremitus
dyspnea
tachypnea
tachycardia

Pneumonia

hacking, painful and usually productive cough
rapid, shallow respirations
chills
headache
fever
dyspnea
pleuritic chest pain
grunting respirations
nasal flaring
decreased breath sounds
crackles and rhonchi
cyanosis
tachypnea
tachycardia