This is a really embarrassing question but I have to ask

[2bRNatasha85]

I'm just started my clinicals and while I am able to hear heart and bowel sounds, I am having difficulties differentiating between normal and adventitious lung sounds, especially over women who are obese or big breasted. At first I thought it was my stethoscope but I had the same problems with other stethoscopes. What is it that I am possibly doing wrong or what can I do to improve on this topic? I've tried listening to the lungs on the simulation dolls at school and youtubed videos but it's so different when you hear it over a patient.

[LadyFree28, BSN, LPN, RN]

Are you attempting to hear lung sounds over breast tissue? Just curious...

Here is a technique to assess respiratory and cardiovascular in females:

[2bRNatasha85]

I think so.

[LadyFree28, BSN, LPN, RN]

Try looking at these You Tube videos:

And listening to these lung sounds:

There are plenty of resources in terms of hearing adventitious lung sounds; it will take practice.

Check you stethoscope as well; the ear pieces should be pointing inward, more in the direction of your ear canal; also, check to see if the bell is open, especially with a double bell. Always tap first on the bell to check if you can hear the tapping; if not, the bell isn't open and you will not hear any sound.

[2bRNatasha85]

Thank you. I was wondering, as a nurse, what do you think of 3M Littmann Cardiology III Stethoscope. Although I do think the ultimate problem is me not being able to differentiate lung sounds, I find that the Littmann lightweight II S.E. stethoschope I have make sounds sound a little muffled.

[Esme12, ASN, BSN, RN]

I have used the Littmann Cardiology III the most durable and accurate stethoscope ....it just takes practice.

[LadyFree28, BSN, LPN, RN]

I've used the Littmann S.E. II for about 10 years without issues...I'm thinking about upgrading to a Cardiology III, but still like my S.E.

Like Esme said, it just takes practice.

[2bRNatasha85]

I wish I had time to practice. I'm sure if I did I'd eventually learn the difference but my clinical professor has warned me if I don't have it down by my next clinical day (Wednesday), then she's going to fail me.

[LadyFree28, BSN, LPN, RN]

I THINK that you can have it down by Wednesday; I think you can find a family meme r or acquaintance to practice on perhaps.

Also did you have skills lab prior to clinicals?

[systoly]

this is NOT embarrassing

i'm not ashamed to say i had the same problem

and even one of my clinical instructors admitted it wasn't

her strongest area

i was fortunate enough to have one of the floor nurses

during clinicals come up to me and say

"let's listen to some musical chests"

perhaps you could ask your instructor to assign you

to pulmonary patients

[smurfynursey]

Lung sounds can be challenging. It takes some practice. I learned using websites, and then ended up working at a facility were 50% of the patients I was caring for had "musical chests" at least once a shift.

[OneDuckyRN]

Lung sounds can be challenging. It takes some practice. I learned using websites, and then ended up working at a facility were 50% of the patients I was caring for had "musical chests" at least once a shift.

This.

Lung sounds are VERY tricky. I don't think I've ever heard lungs that sound like the simulated sounds. I now work on a pulmonary floor, and I feel like that's the biggest reason I've had a lot of practice differentiating different sounds.

Practice as much as you can. I don't think there's any trick you can really learn; it just comes with time. Any time I question what I'm hearing, I have someone else listen.