A slightly obese female client with a history of allergy-induced asthma, hypertension, and mitral valve prolapse is admitted to an acute care facility for elective surgery.
The nurse obtains a complete history and performs a thorough physical examination, paying special attention to the cardiovascular and respiratory systems. When percussing the client’s chest wall, the nurse expects to elicit:
- a. Resonant sounds.
- b. Hyperresonant sounds.
- c. Dull sounds.
- d. Flat sounds.
Answer A.
When percussing the chest wall, the nurse expects to elicit resonant sounds — low-pitched, hollow sounds heard over normal lung tissue. Hyperresonant sounds indicate increased air in the lungs or pleural space; they’re louder and lower pitched than resonant sounds. Although hyperresonant sounds occur in such disorders as emphysema and pneumothorax, they may be normal in children and very thin adults. Dull sounds, normally heard only over the liver and heart, may occur over dense lung tissue, such as from consolidation or a tumor. Dull sounds are thudlike and of medium pitch. Flat sounds, soft and high-pitched, are heard over airless tissue and can be replicated by percussing the thigh or a bony structure.The correct answer is a. Resonant sounds.
Percussion is a physical examination technique used to assess the underlying density of organs or tissues. Resonant sounds are produced when percussing over air-filled structures like the lungs. In this case, the client has a history of asthma, which can affect the lungs' ability to expand and contract effectively. However, the client is not experiencing any acute respiratory distress, and the nurse should expect to hear resonant sounds when percussing over the chest wall.
Option b, Hyperresonant sounds:
is characterized by an abnormally loud, hollow sound produced when percussing over an air-filled structure. This could be indicative of hyperinflation, which is a condition where the lungs are overinflated due to air trapping. While hyperinflation can be associated with asthma, it is not typically present in a stable client with controlled asthma.
Option c, Dull sounds:
are produced when percussing over solid structures like the liver or heart. In this case, the nurse is specifically percussing over the lungs, which are air-filled structures, so dull sounds would not be expected.
Option d, Flat sounds:
are produced when percussing over fluid-filled structures or consolidated lung tissue. Consolidation occurs when the alveoli, the air sacs in the lungs, become filled with fluid or inflammatory cells. While consolidation can be a complication of asthma, it is not typically present in a stable client with controlled asthma.
Therefore, the nurse expects to elicit resonant sounds when percussing the client's chest wall.
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Respiratory