When assessing the respiratory system of a 4-year-old child, which of these findings would the nurse expect?

A) Crepitus palpated at the costochondral junctions
B) Presence of bronchovesicular breath sounds in the peripheral lung fields
C) No diaphragmatic excursion as a result of a child's decreased inspiratory volume
D) Irregular respiratory pattern and a respiratory rate of 40 breaths per minute at rest

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Jason Garcia · Accepted Answer

Final Answer : B, Explanation :  Bronchovesicular breath sounds in the peripheral lung fields of the infant and young child up to age 5 or 6 years are normal findings. Their thin chest walls with underdeveloped musculature do not dampen the sound, as do the thicker chest walls of adults; therefore, breath sounds are loud and harsh. Crepitus is not a normal or expected finding in a child or any age patient. Although the technique of measuring diaphragmatic excursion using percussion is no longer recommended, you would still expect to see diaphragmatic excursion (movement of the diaphragm) in a 4-year-old child. The normal respiratory rate for a 4-year-old child is 20 to 24, so a respiratory rate of 40 while at rest would be tachypnea.

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