Characteristics And Procedure

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CHARACTERISTICS OF RESPIRATION
Resting respirations should be assessed when the client is relaxed. The rate, depth, rhythm and quality and effectiveness of respirations should be assessed. The respiratory rate is normally described in breaths per min.
Respiratory rate
Observe a full inspiration and expiration when counting ventilation or respiration rate. The usual range of respiratory rate declines throughout life.
Acceptable Ranges of Respiratory Rate
Age
Rate (breaths/min)
Newborn
35 — 40
Infant (6 months)
30 -50
Toddler (2 years)
25 -32
Child
20 -30
Adolescent
16 -20
Adult
12 – 20

         Ventilatory Depth

Assess the depth of respirations by observing the degree of movement in the chest wall. Describe ventilatory movements as deep, normal or shallow.
A deep respiration involves a full expansion of the lungs with full exhalation.
Respirations are shallow when only a small quantity of air passes through the lungs and ventilatory movement is difficult to see.
Ventilatory Rhythm
Determine breathing pattern by observing the chest or the abdomen. Diaphragmatic breathing results from the contraction and relaxation of the diaphragm and you observe it best by watching abdominal movements.
Healthy men and children usually demonstrate diaphragmatic breathing
Women tend to use thoracic muscle to breathe, assessed by observing movements in the upper chest
PROCEDURE/ TECHNIOUE FOR CHECKING RESPIRATION
Purposes:
·         To acquire baseline data against which future measurements can be compared
·         To monitor abnormal respirations and respiratory patterns and identify changes
·         To monitor respirations before or following the administration of a general anesthetic or any medications that influences respirations
·         To monitor clients at risk for respiratory alterations (e.g. those with fever, pain, acute anxiety, COPD, asthma)
         Assessment
·         Skin and mucous membranes color (e.g. cyanosis or pallor)
·         Position assumed for breathing (e.g. use of orthopneic position)
·         Signs of cerebral anoxia (e.g. irritability, restlessness, drowsiness or loss of consciousness
·         Chest movement
·         Activity tolerance
·         Chest pain
·         Dyspnea
·         Medications affecting respiratory rate
Equipment
Watch with a second hand or indicator
TPR Sheet
Steps

Steps
Rationale

Introduce yourself and verify the client's identity


Explain to the client what you are going to do, why it is necessary, and how the client can cooperate


Perform hand hygiene and observe other appropriate infection control procedures.


Provide for client privacy


Observe or palpate and count the respiratory rate.


Place clients arm in relaxed position across the abdomen or lower chest OR place nurses hand directly over client's upper abdomen. Or observe the chest movements while supposedly taking the radial pulse.


Count the respiratory rate for 30seconds if the respirations are regular.
Count for 60 seconds if they are irregular.
An inhalation and an exhalation count as one respiration.

Observe the depth, rhythm, and character of respirations.
·         Observe the respirations for depth by watching the movement of the chest.
·         Observe the respirations for regular or irregular rhythm.
·         Observe the character of respirations—the sound they produce and the effort they require
During deep respirations, a large volume of air is exchanged; during shallow respirations, a small volume is exchanged
Normally respirations are evenly spaced
Normally respirations are silent and effortless

Document the respiratory rate, depth, rhythm, and character on the appropriate record.


SPECIAL CONSIDERATIONS:
·         Never make the patient conscious that you are checking respiration.
·         Count the inspiration only.
·         Note the characteristics of respiration.

·         Never check the respiration when client is in tension.

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notes.nursium.com: Characteristics And Procedure
Characteristics And Procedure
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