The knowledge of the normal heart sound, S1 then S2, will aid in the identification of the abnormal heart sounds as the changes of loudness of S1 or the “lub” in “lub-dup” may signify heart pathology. “The second heart sound has been called the key to heart disease” (Shindler, 2007). It is widely transmitted, usually audible, sharper and shorter than S1, and easily heard. Ventricular gallop or S3 is normal in children but not in older populations as it may be associated with heart failure (Huffman, 2012). An S3 is normally a silent event that 's associated with volume or ventricular filling. Heard immediately after S2, an easy way to remember is by pronouncing the word “Kentucky”: S1 is “ken,” S2 is “tuck,” …show more content…
Abnormal sounds are the absence of sound and the presence of specific sounds where they should not be. These sounds are due to accumulation mucus in the passages, compression by a growth, and pleural effusion. The absence of sound may be due to occlusion, partial or total collapse of the lung/s, or massive effusion compressing the alveoli. Crackles and wheezes are adventitious lung sounds which are abnormal sounds over the normal lung sounds (Bradley, 2007). Crackles are caused by atelectasis, or fluid in the small air sacs, audible on inspiration or expiration resembling the sound made by rubbing strands of hair together by the ear. Crackles if widespread may be related to a serious problem may be indicative of pulmonary edema or acute respiratory distress. Wheezes are continuous sounds caused by movement of air through narrow airways due to constriction of muscles such as in asthma, swelling in bronchitis, an obstruction, or spasm. Wheezing leading to hypoxia and cyanosis require emergent …show more content…
When the capillary refill on the hands that are cold, clammy, and pale to begin with, with results lasting more than 1 or 2 seconds, this indicates vessel constriction or decreased cardiac output found in patients that are dehydrated or hypovolemic, with heart failure, or in shock (Jarvis, 2012). Tenting of the skin or receding slowly of the skin when pinched is a way to check for skin turgor which is indicative of severe dehydration or extreme weight loss (Jarvis, 2012). Learning how to distinguish abnormal skin condition can lead to detection of an abnormal system disease (Peters, 2007). Otherwise, skin should be warm and dry to touch, with good skin turgor, <1 second capillary refill, and color appropriate to patients normal