Auscultation of the chest and upper airway should include evaluation for stridor (inspiratory or expiratory) as well as evaluation of breath sounds bilaterally. Diminished breath sounds, crackles, or wheezing should be further evaluated by radiography. Examination of the cardiovascular system should include auscultation of the heart sounds, evaluating new murmurs as they arise, and should also include evaluation of peripheral pulses and perfusion of the skin. Abdominal examination should begin with observation of shape and then proceed to auscultation of bowel sounds followed by palpation. Any changes or abnormalities noted in the examination should be properly recorded and intervention promptly taken to minimize impact on the patient's clinical status. It is important to note that these changes in physical examination can be associated with other disease processes as well as infection.