1. Nurse Assistant in a LTC Facility
Respiration
Nurse Assistant in a LTC Facility

2. RESPIRATION Measures breathing of the patient
Process of taking in oxygen et expelling carbon dioxide from the lungs et respiratory tract
One respiration consists of one inspiration (breathing in, chest rises) et one expiration (breathing out, chest falls)
Inhalation- act of taking in air
Exhalation- act of breathing air out
If you are unable to see pt breathing count how many times the abdomen rises et falls

3. Normal Respiratory Rate
Respiratory rate- the number of respirations in 1 minute
Resp. rate is affected by same factors as those that elevate or lower the pulse
*Adult: breaths per minute (There is no difference in Resp. range for an older adult)
Wider Adult Range: 12 to 20 breaths per minute
Teenagers: 12-16
Children: breaths per minute
Toddlers: 24-40
Preschool: 22-34
Infant: 30 to 50 breaths per minute

4. Characteristic of Respirations
Normal Respirations
Quiet
Effortless
Regular
Both sides of chest rise et fall
Note depth et quality of respirations
deep
shallow
labored, difficult
stertorus (abnormal sounds like snoring)

5. Rhythm Respiration Note rhythm with rate et character
Regularity or equal spacing between breaths
Described as regular (or even) or irregular

6. Abnormal RESPIRATION Eupnea: 16-20 breaths per minute normal pattern
Dyspnea: difficult or labored breathing
Apnea: absence of respirations
Tachypnea: respiratory rate above 25 respirations per minute ex Response to fever
Bradypnea: slow respiratory rate, usually below 10 respirations per minute; Ex response to drug overdose, sleep
Orthopnea: severe dyspnea in which breathing is very difficult in any position other than sitting erect or standing

7. Abnormal RESPIRATION
Cheyne-Stokes: periods of dyspnea followed by periods of apnea; frequently noted in a dying pt
Rales: bubbling or noisy sounds caused by fluids or mucus in air passages

8. Abnormal Respiration Respiration brings fresh air into the body
Example
Caucasian pt breathing normally skin color pink
Caucasian skin or nail bed is blue, gray or dusky= serious problem with intake et use of oxygen
Dark skinned pt look at nail beds, lips et mucous membranes inside mouth!!

9. Voluntary Control of Respirations
Partially under voluntary control
Important to keep pts unaware of the procedure
Because he or she may subconsciously or intentionally alter the pattern
Do not tell the pt you are counting respirations
Count pulse, Keep your hand on the pulse site when measuring respirations. Pts will think you are still taking pulse et the respirations will less likely be altered

10. Measuring Respirations
You must be able to see the chest rise and fall
The resident must not be aware that you are counting their respirations
Count respirations right after counting pulse. The fingers should be left on pulse site.
If resident has apnea, dyspnea, Cheyne-Stokes, or wheezing, report this to charge nurse immediately.

11. Record all Information
Include:
Rate
Character
Rhythm
Example: Date, Time, R18 deep et regular, Your signature et title.