During auscultation of the breath sounds of an adult male client, the nurse hears crackling sounds over most of the chest. Which of the following would be the best action for the nurse to take next?

Question

1. Document this as abnormal.
2. Wet the chest hair before auscultating the chest.
3. Place the diaphragm on top of the client's shirt.
4. Switch from the diaphragm to the bell.

Answer 1

2
Rationale 1: The crackling sounds may or may not be an abnormal finding; the cause of the sounds should be fully investigated before the nurse documents the finding as abnormal.
Rationale 2: Friction on either the bell or the diaphragm from coarse body hair may cause a crackling sound easily confused with abnormal breath sounds. To avoid artifact caused from friction, the nurse should wet the hair on the client's chest before auscultation.
Rationale 3: Auscultating lung sounds over the client's clothing will increase rather than decrease friction sounds.
Rationale 4: Lung sounds are high-pitched sounds, best heard with the diaphragm of the stethoscope. Friction from hair will cause abnormal crackling sounds using either the diaphragm or the bell, so switching them won't make a difference.