Respiratory: Measuring respiration (for nursing assistant training)

Breathing, also known as respiration, is how the air moves into and out of the lungs. It consists of repetitive cycles of inspiration, which is when air full of oxygen flows into the lungs, and expiration, when the air along with carbon dioxide leaves the lungs.

In order for this cycle to happen, there are respiratory centers within the brain that control breathing. These centers receive information from a group of receptors, known as chemoreceptors, which detect any changes regarding the oxygen and carbon dioxide concentration in the body.

Now, as a nursing assistant, you need to be able to measure your clients' respiration and determine its characteristics, including the respiratory rate, rhythm, and depth of respiration and whether the respirations are quiet or noisy as well as easy or difficult.

breaths a client takes in one minute. Normal respiratory rate varies among different age groups.

So, for adults, it’s typically between 12 and 20. For adolescents between 12 and 20 years old, normal respiratory rate is 15 to 20.

For school-aged children between 5 and 12 years old, it’s from 15 to 25. For preschoolers from 3 to 5, it’s 22 to 34, while toddlers from 1 to 3 have a normal respiratory rate of 24 to 40.

Finally, infants under 1 year of age normally have the fastest respiratory rate, which ranges from 30 to 60 breaths per minute.

influenced by many factors, including physical activity; body temperature; emotions, like anger, fear, or stress; medications; smoking; certain diseases of the heart or lungs; or even the weather!

A client can also voluntarily choose to increase their respiratory rate or hold their breath and, thus, decrease their respiratory rate.

So, tachypnea is when the respiratory rate is faster than normal, and this can occur in response to strenuous exercise, fever, pain, anxiety, or specific medications.

In contrast, bradypnea means that the respiratory rate is too slow and can be due to respiratory problems or various medications.

which is normally regular, meaning that the intervals between the breaths are approximately equal. In an irregular rhythm, the breaths do not follow an even tempo and some of them might even be skipped.

This can be a result of lung problems or a complication of a stroke or brain damage. the lungs: a process called ventilation.

Normal ventilation keeps the body in balance because the amount of carbon dioxide removed by the lungs is equal to the amount the body produces.

Hypoventilation, or breathing that is too shallow or too slow to meet the needs of the body, means that the lungs can't keep up with the carbon dioxide the body produces, so the level of carbon dioxide in the body rises, and there is not enough oxygen.

Hypoventilation can be caused by prolonged bed rest, if a client is reluctant to breathe normally when breathing causes pain, or by an overdose of certain drugs.

On the other hand, during hyperventilation, which is breathing that is too fast or deep, carbon dioxide is removed faster than the body produces it.

Hyperventilation happens normally during exercise but also can be caused by extreme fear or anxiety or when a diabetic client's blood sugar gets too high.

by dyspnea, or shortness of breath, where breathing gets difficult, uncomfortable, or even painful. when measuring a client's respiration, there are some common care tips you need to remember.

First of all, you can count the number of respirations by looking at the client’s chest rising as they take a breath in and falling as they breathe out.

Some clients, particularly young children and the elderly, use the muscles of the abdomen predominantly to help them with breathing.

For these clients, you can look at the movements of the abdominal wall. In any case, one rise or inhalation plus one fall or exhalation equals one breath.

It may help to bend down a little bit so that you can position yourself at the level of the client's chest or abdomen. movements are subtle, is to position your hand over their chest or abdomen so that you can feel it rise and fall.

Another important thing to keep in mind is that the client should not be aware that you're counting their respirations until after you're done so that they don't modify their respiratory rate.

The best way to do that is to measure the respiration right after you've measured pulse rate and while you still keep your finger on their radial artery.

In this way, they'll think you're still counting their pulses. Another good idea would be to count respirations while they're asleep.

check with the care plan and the nurse to find out when and how often respiration should be measured and if the nurse has any concerns about the client you should know about.

You can then gather the supplies you’ll need, including a watch. Remember to also practice hand hygiene.

Make sure that their chest or abdomen is visible. You can then look or place your palm on their chest or abdomen and feel for the rise and falls.

Count the first breath, or full cycle of breathing in and out, as zero. The second breath is one, the third breath is two, and so on.

Now, measure the number of breaths according to your facility policy. So, for example, if the respiration is regular, you can count how many breaths occur in 30 seconds and multiply by two to get the respiratory rate.

If the rhythm isn’t regular, you should count the number of breaths in a full minute. A full minute of respiration needs to be counted in infants, too.

While you count, notice whether respirations seem shallow or deep. a comfortable position, and remember to practice hand hygiene.

when measuring a client’s respiration, there are a few things you should report to the nurse right away, such as a respiratory rate above or below normal or a value specific for the client, an irregular respiratory rhythm, or breathing that is too shallow or too deep.

Let the nurse know if the client seems to experience shortness of breath or if you notice an uneven chest expansion. Also, observe for any unusual whistling or croaking breath sounds.

Finally, remember to document the date; time; respiratory rate, rhythm, and depth; and any observations you made while measuring the client's respiration.

as a quick recap... Breathing, or respiration, consists of cycles of inspiration, when air flows into the lungs, and expiration, when air leaves the lungs, allowing the exchange of oxygen and carbon dioxide.

It’s characterized by a respiratory rate, which is the number of respiratory cycles per minute; a respiratory rhythm, which can be regular or irregular; and a depth of respiration, which reflects the volume of air breathed in or out.

It is typically obtained by looking at the client’s chest or abdomen rising and falling or placing the palm over their chest or abdomen to feel for the movements.

Remember to report any unusual signs or symptoms to the nurse and document the respiratory rate, rhythm, and depth along with your observations.