Note any abnormal (adventitious) sounds such as wheezes, crackles (rales), rhonchi, or stridor. Normal lung sounds include vesicular, bronchial, and bronchovesicular sounds.When you move the stethoscope, make sure you listen to at least one full breath cycle at each location.Ask the client to breathe in and out deeply through the mouth. Place the stethoscope directly on the client skin, not over clothing.Make sure to auscultate corresponding areas on both sides of the chest for comparison. Listen to both the front (anterior) and back (posterior) of the chest. Start at the top (near the collarbone) and work downward to the bottom (base) of the lungs.Use a stethoscope with a diaphragm (better for listening to lung sounds which are relatively high-pitched).
Note the inspiratory to expiratory ratio.When abnormalities are found, listening to several breaths in that location may be necessary. Listen to inspiration and expiration in each location.Compare sounds in the apices to sounds in the bases. Compare sounds heard on one side to sounds heard in the same location on the opposite side.Auscultate all areas systematically including anterior, posterior, and lateral lung fields.The presence of chest hair may require firmer pressure to eliminate any potential interference. Use the diaphragm of the stethoscope, placed firmly and directly on the skin.Have the patient sit upright if possible, breathing slowly and deeply through an open mouth.In conjunction with percussion, auscultation helps to evaluate the surrounding pulmonary parenchyma and pleural space.
Auscultation evaluates air flow through the tracheopulmonary tree, the presence of added or adventitious breath sounds, and transmission of the patient's spoken voice. Auscultation provides important information regarding the lungs and pleura.