China
Africa
Explore chapters and articles related to this topic
Measuring and monitoring vital signs
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
You should also observe the sound of breathing, which is normally quiet. You may hear a variety of abnormal breath sounds. A wheeze, often heard in people with asthma, is a high-pitched sound occurring when air is forced through narrowed respiratory passages. A wheeze may also occur with chest infections. A stridor is a harsh, high-pitched sound that is heard during respiration when the larynx is obstructed.
The patient with acute respiratory problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
The areas previously percussed are then auscultated, using the diaphragm of the stethoscope to listen for breath sounds. The sounds produced on one side of the chest are compared to the other side. Normal breath sounds over the anterior and posterior chest wall are vesicular, which are soft, low-pitched sounds where the inspiratory phase is shorter than the expiratory phase. If bronchial sounds are heard, this may suggest an area of consolidation. Bronchial breath sounds are loud and high-pitched, with the inspiratory phase shorter than the expiratory phase. As well as breath sounds, there may be additional breath sounds (adventitious sounds), such as crackles and wheezes. Coarse crackles are usually heard on inspiration with problems such as infection, pulmonary oedema (fluid in the alveoli as a result of left ventricular heart failure) and fine inspiratory crackles in pulmonary fibrosis or in the re-expansion of collapsed alveoli. Wheezes are usually expiratory and can be heard in acute asthma and in chronic obstructive pulmonary disease. Differences in the transmission of voice sounds can also be heard during auscultation. Where there is consolidation, the sounds produced by asking the patient to say ‘99’ will be heard more loudly through the stethoscope as compared to the healthy side; this is called bronchophony. Bronchophony is conversely diminished where there is air present and absent over a pleural effusion or significant pneumothorax.
Pulmonary Tuberculosis
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Charles S. Dela Cruz, Barbara Seaworth, Graham Bothamley
There are few clinical signs of pulmonary TB. The cavitation obscures any sign of consolidation due to infiltration of the lung parenchyma. Crackles are rarely audible compared to normal breath sounds. Cavities cannot be demonstrated by percussion and auscultation unless huge.
Mycobacterium goodii central venous catheter-related bloodstream infection
Published in Baylor University Medical Center Proceedings, 2023
Anusha Ammu, Busara Songtanin, Sarath Nath
A 41-year-old woman with a history of type 2 diabetes, chronic hypoxic respiratory failure, and pulmonary hypertension on epoprostenol infusion presented to the hospital with fever, nausea, dysuria, and dyspnea for 2 days. She denied cough, peripheral edema, abdominal pain, and diarrhea. The blood pressure was 109/70 mm Hg; temperature, 100.1°F; heart rate, 117 beats/min; respiratory rate, 17 breaths/min; and oxygen saturation, 93% on 2 L oxygen (baseline home oxygen). Examination showed normal breath sounds. There was no erythema, swelling, bleeding, drainage, or tenderness at the right subclavian catheter site and no peripheral embolic signs. The catheter had been inserted for epoprostenol infusion therapy for pulmonary hypertension 1 year before this admission. The white cell count was 3.47 k/µL (neutrophils 90%, lymphocytes 6%); hemoglobin, 11.0 g/dL; and platelet count, 82 k/µL. Urinalysis showed no red blood or pyuria, no bacteria, and negative leukocyte esterase and nitrite. Chest x-ray showed no infiltrates. Computed tomography of the chest without contrast showed a small pericardial effusion. A transthoracic echocardiogram was negative for valvular abnormalities. The patient had persistent temperatures up to 103.5°F.
Pheochromocytoma with Acute Non-cardiac Pulmonary Edema: A Report of One Case and the Review of Literature
Published in Cancer Investigation, 2021
Yuan Liu, Ning Wang, Shi Li, Ling Jiang, Chunfang Liu, Jian Xu, Huadong He
Physical examination on admission showed that the body temperature was 37.3 °C, the heart rate was 112 beats/min, the respiratory rate was 26 beats/min, and the blood pressure was 75/50 mmHg. The patient had clear mind, cold and wet skin, medium nutrition. The superficial lymph nodes were not palpable and enlarged, the neck was soft, and the trachea was in the middle. The breath sounds of both lungs were thick, and the dry and wet rales can be heard widely, without pleural friction. The abdomen was flat and soft, and the liver and spleen were not touched under the ribs. There was no abdominal tenderness or rebound pain. The muscle strength and tension of limbs were normal. Neurological examination was also normal. The results of biochemical indexes are shown in Table 1. The other antinuclear antibodies and antineutrophil antibody (ANCA) were normal. Stool routine examination and electrocardiogram (ECG) were normal.
Complications from Needle Thoracostomy: Penetration of the Myocardium
Published in Prehospital Emergency Care, 2021
Arielle Thomas, K. Hope Wilkinson, Kevin Young, Timothy Lenz, Jillian Theobald
A 206-lb average sized adult male, traveling at highway speeds without a helmet, struck debris in the roadway and was thrown from the motorcycle. When ground emergency medical services (GEMS) arrived, the patient was unresponsive. He became pulseless and CPR was initiated. He also received two rounds of epinephrine and two manual defibrillations before regaining pulses as helicopter emergency medical services (HEMS) arrived. The airway was secured with a King LTS-D device. Breath sounds were coarse with good aeration on the right side and with significantly diminished air movement and faint rales on the left. There were no palpable chest wall deformities and no visible open chest wounds or flail segments. The patient was given packed red blood cells (PRBCs) and crystalloid fluid infusion for hypotension with little response. HEMS performed needle decompression of the left chest with a 14-gauge angiocatheter (1.75 inches in length) placed in the 2nd intercostal space on the MCL. Reassessment of breath sounds revealed slightly improved air movement on the left, however still decreased when compared to the right.