一位病患正處於氣喘急性發作。護理師在聽診時應預期聽到哪種呼吸音？

氣喘（Asthma）的核心病理生理是支氣管平滑肌痙攣、黏膜水腫與分泌物增加，導致下呼吸道狹窄。當空氣通過狹窄的管道時，會產生高頻率的連續性雜音，即哮鳴音（Wheezing）。這通常在呼氣期最明顯。相對地，粗囉音（Coarse crackles）多與肺泡內積水或大量分泌物有關（如肺炎、心衰竭）；肋膜摩擦音（Pleural friction rub）與肋膜發炎有關；喘鳴（Stridor）則是上呼吸道（喉部、氣管）阻塞的特徵，屬於急診中的急症。在氣喘照護中，若聽診發現「安靜肺部」（Silent chest），即原本的哮鳴音消失且呼吸音極弱，代表氣道已完全阻塞，優先級甚至高於哮鳴音，需立即搶救。

The core pathophysiology of asthma involves bronchial smooth-muscle spasm, mucosal edema, and increased secretions, leading to narrowing of the lower airways. As air passes through the narrowed passages, a high-pitched, continuous sound is produced: wheezing. This is typically most prominent during expiration. By contrast, coarse crackles are more often associated with fluid or copious secretions in the alveoli (as in pneumonia or heart failure); a pleural friction rub is related to pleural inflammation; and stridor is characteristic of upper airway (laryngeal or tracheal) obstruction and represents an emergency. In asthma care, the finding of a 'silent chest', in which previously audible wheezing disappears and breath sounds become very faint, indicates complete airway obstruction and is an even more urgent priority than wheezing, requiring immediate resuscitation.

美國 NCLEX 非常強調「Silent Chest」的辨識（即哮鳴音消失反而是惡化的徵兆）；台灣臨床護理教育亦涵蓋此點，但在實務上，台灣護理師可能更早依賴噴霧治療（Nebulizer）後的尖峰呼氣流量（PEFR）測量來量化評估。