A nurse is auscultating the breath sounds of a client who has congestive heart failure. When the client exhales, the nurse hears bubbling, popping like sounds. The nurse should document this as which of the following adventitious breath sounds?
A.
Wheezes
B.
Stridor
C.
Rhonchi
D.
Crackles
The Correct Answer and Explanation is:
The correct answer is D. Crackles.
Explanation:
When auscultating breath sounds, particularly in a client with congestive heart failure (CHF), it’s crucial to accurately identify and document adventitious (abnormal) breath sounds. In this scenario, the nurse hears bubbling, popping-like sounds during the client’s exhalation. These sounds are characteristic of crackles.
Crackles (or rales) are discontinuous, high-pitched sounds that can be heard during inhalation or exhalation, though they are most commonly associated with inspiration. They result from the sudden opening of small airways or alveoli that have been collapsed or filled with fluid. In the context of CHF, crackles are often due to the accumulation of fluid in the alveoli and bronchioles, which is a common manifestation of pulmonary congestion associated with heart failure.
Here’s a brief overview of the other options for context:
- A. Wheezes: Wheezes are continuous, high-pitched, musical sounds that occur during expiration or inspiration. They result from the narrowing or obstruction of the airways, often seen in conditions like asthma or chronic bronchitis. Wheezes are not typically described as bubbling or popping sounds.
- B. Stridor: Stridor is a high-pitched, continuous sound heard primarily during inspiration. It results from upper airway obstruction, such as in cases of croup or foreign body aspiration. Stridor is not commonly associated with CHF and is not described as bubbling or popping.
- C. Rhonchi: Rhonchi are low-pitched, continuous sounds that resemble snoring or rumbling. They occur due to the obstruction or turbulence in larger airways, often associated with conditions like bronchitis. While rhonchi can be associated with CHF due to mucus accumulation, they are more often described as having a lower-pitched, more rattling quality compared to crackles.
In summary, the bubbling, popping sounds described are best classified as crackles. They indicate the presence of fluid in the airways and alveoli, a common finding in patients with congestive heart failure due to pulmonary edema. Accurate documentation of these sounds helps guide appropriate management and treatment for the patient.