A nurse is assessing a client who has pneumonia. Which of the following manifestations should the nurse expect?
A.
Crackles.
B.
Crepitus.
C.
Stridor.
D.
Decreased fremitus.
The Correct Answer and Explanation is:
The correct answer is A. Crackles.
Explanation:
Pneumonia is an infection of the lungs that causes inflammation and fluid accumulation in the alveoli (the small air sacs where gas exchange occurs). This condition leads to characteristic clinical manifestations that nurses must be able to recognize. Let’s break down each option to understand why crackles are expected and the others are not.
A. Crackles: Crackles, also known as rales, are a common finding in patients with pneumonia. These sounds occur when air moves through fluid-filled or inflamed alveoli, which happens in pneumonia due to infection and exudation (fluid build-up). Crackles are often heard during inhalation and sound like popping or crackling. They can be fine or coarse, depending on the severity of the condition. This occurs because the normal air spaces in the lungs are filled with fluid or pus, a hallmark of pneumonia. Nurses often hear crackles in the lower lung fields where fluid tends to accumulate.
B. Crepitus: Crepitus refers to a crackling or grating sound produced by air bubbles trapped under the skin, typically caused by subcutaneous emphysema. This is not a common manifestation of pneumonia but can occur in other conditions like trauma or chest wall injury. Crepitus is more commonly associated with pneumothorax or severe injury rather than an infection like pneumonia.
C. Stridor: Stridor is a high-pitched, wheezing sound typically associated with upper airway obstruction, such as in croup, epiglottitis, or a foreign body lodged in the airway. It indicates a narrowing of the large airways and is not a typical finding in pneumonia, which affects the lungs’ lower respiratory areas.
D. Decreased fremitus: Fremitus refers to the vibrations felt on the chest wall when a patient speaks. In pneumonia, fremitus is often increased due to the lung consolidation (solidification of the lung tissue). Decreased fremitus is more common in conditions like pleural effusion or pneumothorax, where fluid or air separates the lung from the chest wall, reducing the transmission of vibrations.
In conclusion, crackles are the expected finding in pneumonia due to fluid-filled alveoli, while the other options are more indicative of different conditions. Recognizing crackles is important for timely diagnosis and treatment of pneumonia, helping to prevent complications.