2-9.
ABNORMAL RESPIRATIONS
a. Dyspnea. Difficult or labored breathing, normally requiring considerable
exertion by the patient.
b. Apnea. Temporary cessation of breathing. A period of apnea may last for
30-60 seconds.
c. Tachypnea. Quick, shallow breathing.
d. Bradypnea. Abnormal slowness of breathing.
e. Hypoventilation. A state in which there is a reduced amount of air entering
the pulmonary alveoli.
f. Hyperventilation. A state in which there is an increased amount of air
entering the pulmonary alveoli.
g. Stertorous Respiration. Breathing accompanied by abnormal snoring
sounds.
h. Cheyne-Stokes Respiration. An irregular rhythmic breathing pattern that
begins with slow, shallow respirations that increase in rate and depth and then gradually
decline again. A period of apnea lasting 10-60 seconds follows, and the pattern then
repeats itself.
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.
MD0917
2-8