How to Auscultate the Lungs
Ausculating the lungs means listening to the breath sounds with a stethoscope. It is an essential part of a clinical exam. Nurses, doctors and respiratory therapist auscultate the lungs to help determine what type of respiratory condition a patient has. Certain lung sounds tend to be present with certain conditions. Conditions such as asthma, congestive heart failure and pneumonia can be detected. Listening to lung sounds also helps determine what type of treatment and medication may help. Learning to auscultate the lungs efficiently and identifying various lung sounds takes practice.
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Instructions
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Minimize the noise in the room. Turn off the television and radio. Explain to the patient what you are going to do.
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Make sure the diaphragm of the stethoscope is turned on. Put the ear pieces in your ears and gently tap on the flat diaphragm. If you can't hear anything, turn the head of the diaphragm to turn it on.
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Have the patient sit upright if possible. Start in the upper lung fields. Place the diaphragm of the stethoscope on the patient's upper back on the left side to listen to the posterior upper lobes of the lungs. Although a thin hospital gown or t-shirt should not interfere with auscultation, it's best to place the stethoscope on bare skin.
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Instruct the patient to take a deep breath through her mouth. As the patient inhales, listen to the sounds in the lungs. Move the stethoscope to the opposite of the body, but at the same level. Always listen to both sides of the lungs to compare the sounds. Every time you listen to a new segment of the lung have the patient inhale.
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Move the stethoscope down a few inches and listen to another segment of the lung on both sides.
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Put the stethoscope on the front of the patient's chest to listen to his anterior lobes of the lungs. Repeat the same pattern as with the back, starting at the top and working your way down. Listen to one side of the body and move to the other.
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Identify abnormal lung sounds. The most common abnormal lung sounds include wheezing, rhonchi, stridor and rales. Each has a distinctive sound and possible cause. According to the University of Maryland Medical Center, wheezing is often caused by constricted airways and is a high-pitched sound and may occur with asthma or emphysema. Rhonchi sounds similar to snoring and can occur with fluid in the lungs caused by a condition such as congestive heart failure. Stridor may indicate croup and is a narrowing of the upper airway. It usually sounds like wheezing on exhalation over the trachea. Rales sounds like bubbles popping and can occur with pneumonia due to the fluid in lungs.
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