rhonchi dilema?are you a wheeze or not?

[onduty23]

i am confuse. i have breath sound cd and books that classified rhonchi as a wheeze. but my floor educator and other nurses say otherwise. she say rhonchi is junk in the airway and differs from wheezing. the cd says high pitch wheeze is sibilant rhonci and low pitch wheeze is sonorous rhonchi.my question is why folks keep saying they are different when in fact they are not?

opinions?

[Chaya, ASN, RN]

I always learned they are different. Wheezes are described as having a "musical" quality; once you hear that there is nothing else that sounds quite like it. A person who is wheezing may have junk in the airway but the basic sound is from swelling in the airway. Another difference is often the pt can clear rhonchi, at least momentarily with a cough.

[Ariesbsn]

onduty23,

Breath sounds vexed me to no end until I quit trying to match what I was hearing when I did my assessments with the video sounds we had in school. Nothing in real life has sounded like it did on the video. I have been out of school for a little over 2 years and what I have found is that every RT I ask has a different answer when it comes to breath sounds. I had one RT tell me that there were coorifice or fine crackles and wheezes and that was it. I've had others give 5 word names to sounds.

When I first started I would frequently go into my pt's room with the RT and do my assessment when they do theirs and say "This is what I think I heard, what did you hear?" Sometimes, if the RT wasn't busy, and I heard something odd, I would ask them to come listen and tell me what it is that I was hearing.

The following comes from http://forums.studentdoctor.net/showthread.php?t=350651

"Breath sound are divided into Vesicular breath sounds(Normal) and Adventitious breath sounds (abnormal). Adventitious breath sounds are divided in Continuous lung sound (>80 ms) and Discontinuous lung sounds (

Continuous lung sounds consist of Wheeze and Rhonchi.

Wheeze is high pitched musical sounds especially produced in the setting of Bronchospasm ,mucosal edema or excessive secretions.

Rhonchi is low pitched sonorous sound and may have gurgling quality. They originate in larger airways when there are excessive secretions and abnormal airway collapsibility due to repetitive rupture of surfactant film covering alveoli. Rhonchi frequently clear after cough post tussive clearing. Always ask patient to turn aside and cough if u hear abnormal breath sounds.

Now coming to discontinuos sound those are Crackles or rales.

Coorifice >10 ms and fine crackles

Coorifice crepts are caused by air bubbling through fluid they are loud and low pitched sounds produced in Pneumonia, obstructive lung disease and chronic pulmonary edema."

I hope that helped.

[onduty23]

thanks

[onduty23]

low pitch wheeze is rhonchi