See Figure 3.11 for the placement pattern. Step 3:Place the stethoscope’s diaphragm on the chest in about four to eight locations on each side of the posterior thorax and then at three locations on the right lateral thorax and at two locations on the left lateral thorax so that you listen to all lung lobes. Also be aware that older adults may have difficulty taking a big breath. You should notify them that they can take a break and breathe normally if they need to. Keep in mind that breathing a bit more deeply may trigger shortness of breath or dizziness for some clients.Instruct the client to breathe through the mouth because this makes it easier for you to listen to lung sounds, particularly if there is any nasal congestion or obstructions.
Step 2: Ensure the client is in an upright position and ask them to take a big breath in and out through the mouth each time they feel the stethoscope on their posterior thorax. Step 1: Perform hand hygiene and cleanse the stethoscope. Change the dressing as prescribed, identifying any indications of infection or nonhealing at the insertion site.Posterior and Lateral Thorax – AuscultationĪuscultating the posterior and lateral thorax involves the following steps (see Video 3.5):
Assess the client’s lungs for re-expansion:.Instruct the client about the chest tube removal process and inform them that they may have to take a deep breath and hold when it is removed (Valsalva maneuver) to prevent air from reentering the pleural space.
Prepare the client for removal of the chest tube:.Expected outcomes after completing the procedure include re-expansion of the lung, client comfort, and healing of the chest tube insertion site without complications, such as infection. The information below summarizes nursing responsibilities before, during, and after the procedure. Absence of bubbling in the water seal chamber during expiration.Indications for chest tube removal include the following : The removal of a chest tube is performed by a health care provider such as a physician, physician’s assistant, or nurse practitioner.