Adventitious Breath Sounds

Definition

Adventitious breath sounds are abnormal sounds superimposed on normal breath sounds, heard on auscultation. Accurate identification and documentation guide respiratory diagnosis and nursing intervention.

Common Types

• Crackles (rales): Fine or coarse popping sounds; indicate fluid in alveoli, such as heart failure, pneumonia, pulmonary edema.
• Wheezes: High-pitched whistling sounds; suggest narrowed airways, such as asthma, COPD, bronchospasm.
• Rhonchi: Low-pitched snoring sounds cleared by coughing; mucus in large airways (bronchitis).
• Stridor: High-pitched inspiratory crowing; upper airway obstruction. Emergency!
• Pleural friction rub: Grating sound; pleuritis or pleural inflammation.

Assessment Technique

Auscultate systematically from apex to base, anterior and posterior, comparing side to side. Instruct the patient to breathe deeply through the mouth. Document location, timing (inspiratory/expiratory), and quality.

Nursing Interventions

Elevate head of bed, encourage coughing and deep breathing or incentive spirometry, suction as needed, administer bronchodilators or diuretics as ordered. Stridor requires immediate airway management.

NCLEX Relevance

Essential cue recognition in NGN case studies. Frequently asked to prioritize based on breath sound findings.