A nurse is performing respiratory assessment of a patient. Which of the following indicates the presence of consolidation of lungs?

Question

Question

This question was previously asked in

KGMU Nursing Officer 2023 Memory-Based Previous Year Paper

Answer 1

Correct Answer: Increased tactile fremitus

Rationale:

Consolidation of the lungs refers to a condition where the lung tissue becomes firm and solid due to the accumulation of fluid, pus, blood, or other substances in the alveoli. This is often seen in conditions such as pneumonia.
Tactile fremitus is the palpable vibration felt on the chest wall when a patient speaks. Normally, sound travels through air-filled lungs, and the vibrations are moderate. However, in consolidation, the lung tissue becomes denser, allowing sound to travel more efficiently, thereby increasing tactile fremitus.
Increased tactile fremitus is a key clinical sign indicating the presence of consolidation, as the denser lung tissue conducts vibrations more effectively compared to healthy, air-filled lungs.

Explanation of Other Options:

Tracheal deviation

Rationale: Tracheal deviation occurs when the trachea shifts from its normal midline position. This is usually associated with conditions such as pneumothorax, pleural effusion, or large masses in the thorax, rather than consolidation. It is not a reliable indicator of lung consolidation.

Hyper-resonant percussion note

Rationale: A hyper-resonant percussion note indicates increased air in the lungs or pleural space, as seen in conditions like pneumothorax or emphysema. In consolidation, percussion is more likely to yield a dull sound due to the presence of dense material in the lungs.

Decreased vocal resonance

Rationale: In consolidation, vocal resonance (the transmission of voice sounds through the lung fields) is typically increased rather than decreased. This is because the denser lung tissue conducts sound more effectively. Decreased vocal resonance is more commonly associated with conditions like pleural effusion, where fluid in the pleural space dampens sound transmission.

Conclusion:

The presence of increased tactile fremitus is a hallmark sign of lung consolidation. It occurs due to the enhanced transmission of sound vibrations through denser lung tissue. Other options, such as tracheal deviation, hyper-resonant percussion note, and decreased vocal resonance, are associated with different pulmonary conditions and are not indicative of lung consolidation.