Characteristics And Procedure

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.