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Nursing 2220 The Respiratory System Nursing Assessment (Auscultation)

Nursing 2220 The Respiratory System Nursing Assessment (Auscultation). By Ginger VanDenBerg. Respiratory & Auscultation Course Objectives. Discuss upper and lower respiratory anatomy Discuss ventilation versus oxygenation Identify nursing auscultation assessment of the respiratory system

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Nursing 2220 The Respiratory System Nursing Assessment (Auscultation)

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  1. Nursing 2220The Respiratory System Nursing Assessment (Auscultation) By Ginger VanDenBerg

  2. Respiratory & AuscultationCourse Objectives • Discuss upper and lower respiratory anatomy • Discuss ventilation versus oxygenation • Identify nursing auscultation assessment of the respiratory system • Define assessment of normal versus abnormal respiratory sounds

  3. Respiratory AnatomyOverview • Upper Respiratory System -Nasal Cavity -Oral Cavity -Pharnyx

  4. Respiratory AnatomyOverview • Lower Respiratory System -Larnyx (Opening of the trachea) -Trachea (Windpipe) -Lungs (right/left) -Bronchus (divides into right/left) Upper & Lower Respiratory anatomy is consider to be the CONDUCTING portion No Gas Exchange Occurs

  5. Respiratory Anatomy Overview • Terminal Bronchioles (<1mm diameter • Alveolar Ducts • Alveolar Sacs -Actual units of gaseous exchange in lungs Respiratory bronchioles to alveoli is consider to be the Respiratory Portion Gas Exchange does occur

  6. POP Quiz • Structures of the upper airway include all of the following except? • Nasal Cavity • Oral Cavity • Pharnyx • Larnyx

  7. Nursing Auscultation Assessment • Place the diaphragm of your stethoscope over the posterior chest between the ribs • Ask patient to take slow – deep breaths • Listen to an entire inspiration & expiration cycle at each position • Compare the sounds in one region to sounds in the same region on the opposite side • Anterior follows same pattern as posterior, with attention to the lower lobes for increased secretions

  8. Normal Breath SoundsPosterior Thorax Posterior Thorax Sounds • Bronchovesicular– medium pitched blowing sounds, between the scapulae. Equal inspiratory & expiratory phases • Vesicular- heard over the lung periphery, smaller airways, soft & low pitched. Inspiratory phase is about 3x longer than expiratory phase

  9. Normal Breath SoundsAnterior Thorax Anterior Thorax Sounds • Bronchovesicular & vesicular sounds-are heard above & below the clavicles and along the lung periphery • Bronchial-loud, high pitched, hollow sound, heard over the trachea, expiration last longer than inspiration

  10. POP Quiz • During auscultation the nurse compares lung sounds on one side of the body to lung sounds in the same field on the opposite of the body? • True • False

  11. Abnormal Breath Sounds(Adventitious) • Crackles-heard in dependent lobes, lung bases, sudden reinflation of alveoli. Bowl of rice krispies • Ronchi-heard over trachea & bronchi, caused by muscular spasm, fluid or mucus in larger airways, turbulent sound • Wheezes-heard over all lung fields, high-velocity airflow through narrow bronchus • Pleural friction rub-heard over anterior lung surface, parietal pleura rubbing against visceral pleura

  12. Final POP Quiz • The following lungs sounds are considered to be advantitious except? • Crackles • Ronchi • Vescular • Wheezes

  13. The End Questions and Answers Please referred to the our assigned discussion board for questions and answers

  14. References • Nursing Assessing Lung Sounds (n.d.). Retrieved from http://www.barcharts.com/Inventory/Navision/97815722276133. • Potter, P. A., Perry, A. G., Stocker, P. A. & Hall, A. (2010). Basic Nursing (7th ed.), St. Louis, MO: Elsevier Health Science. • Respiratory System (n.d.). Retrieved from http://www.medical/exam-essentials.com/respiratory-system-diagram.html.

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