2-10
2-10. CHEST AUSCULTATION
a. Auscultation (listening with a stethoscope) aids in assessing air flow through the lungs and determining the presence of fluid or mucus. Breath sounds vary according to the proximity of the large bronchi. Sounds are louder and courser near the large bronchi and over the anterior chest in general. Peripherally, the sounds are softer and finer.
b. To auscultate the chest, have the patient sit erect, or position the patient first on one side and then on the other if the patient is unable to sit. With a stethoscope, listen to the lungs as the patient breathes in and out with the mouth open. Follow a methodical pattern, comparing symmetrical areas on the left and right, traveling from apex to base. Listen both anteriorly and posteriorly.
c. Breath sounds, the sounds of air moving into the lungs during inspiration and out during expiration, should be clearly heard over all lung fields. Normal breath sounds are smooth and clear. Wheezing, rattling noises, or the absence of sound over a particular area is abnormal.
d. Nursing personnel should always auscultate the patient's lungs before and after percussion or coughing and deep breathing exercises. In this way, an observation regarding the effectiveness of the treatment can be made.
