Lung Sounds

A lung sound is one piece of a respiratory assessment, not a diagnosis. Before placing the stethoscope, observe the client's position, colour, alertness, ability to speak, respiratory rate, depth, rhythm, and effort. Accessory-muscle use, nasal flaring, intercostal retractions, tripod positioning, or inability to complete a sentence indicate increased work of breathing. A client who is becoming drowsy may be tiring, even if the respiratory rate is no longer rising. Check oxygen saturation with a reliable signal and compare it with the client's baseline and prescribed target. SpO₂ reflects oxygenation, not ventilation; a normal value does not exclude hypoventilation or rising carbon dioxide. Motion, poor peripheral perfusion, and a loose sensor can produce misleading readings, so verify the probe and waveform when the number does not fit the clinical picture. Do not delay emergency action while trying to obtain a perfect reading from a visibly deteriorating client. Ask about breathlessness, chest pain, cough, sputum, fever, smoking or irritant exposure, and known asthma or COPD. The change from baseline often matters more than the isolated sound. A client with chronic wheezing may...