1. Chapter 1 Vital Signs Copyright © The McGraw-Hill Companies, Inc.

2. Chapter 9 2 Signs 3 Respiration

3. Copyright © The McGraw-Hill Companies, Inc. Chapter 9 3 Respiration Respiration (R) is the act of breathing. Respiratory Rate (RR) – Observe the client’s chest movement upward and outward for a complete minute. – Children under 7 years of age use abdominal breathing. – Auscultation with a stethoscope may be necessary on clients who are aware that you are counting their respiratory rate.

4. Copyright © The McGraw-Hill Companies, Inc. Factors affecting Respirations Factors increase the rate: Exercise Increase metabolism Stress pain Increased environmental temperature Lowered oxygen concentration

5. Copyright © The McGraw-Hill Companies, Inc. Factors decrease respiration rate: Decreased environmental temperature Certain medications such as narcotics Increased intra cranial pressure

6. Copyright © The McGraw-Hill Companies, Inc. Mechanics and regulation of breathing During inhalation, the diaphragm contracts the ribs move upward and outward, and the sternum moves outward, thus enlarging the thorax and permitting the lungs to expand. During exhalation. The diaphragm relaxes, the ribs move downward and inward, and the sternum moves inward, thus decreasing the size of the thorax as the lungs are compressed.

7. Copyright © The McGraw-Hill Companies, Inc.

9. Chapter 9 9 Respiration (cont.) Characteristics of Respiration – Rate of Respiration – the number of breaths per minute. Normal range is16( 12 to 20) breaths per minute for an adult. Rate will vary with age and size of client. Child (age1 to12) –20(15-30)bpm Infant( birth to 1 year)-30(25-50 bpm)

10. Copyright © The McGraw-Hill Companies, Inc. Normal respiratory charateristics 1- Effortless 2- Automatic 3- Noiseless 4- Free from discomfort Chapter 9 10

11. Copyright © The McGraw-Hill Companies, Inc. Chapter 9 11 Respiration (cont.) Characteristics of Respiration – Rate of Respiration (cont.) An increased respiratory rate is called hyperventilation. A decrease in respiratory rate and depth is called hypoventilation. – Rhythm of Respiration – should be regular. – Quality of Respiration Can be shallow or deep.

12. Copyright © The McGraw-Hill Companies, Inc. Respiration depth; is generally described as normal, deep, or shallow. Deep respirations; large volume of air is inhaled and exhaled, inflated most of the lungs. Shallow breathing involve the exchange of a small volume of air and often the minimal use of a lung tissue Hyperventilation; refers to very deep, rapid respiration. Hypoventilation; refers to very shallow respirations

13. Copyright © The McGraw-Hill Companies, Inc. Respiratory rhythm refers to the regularity of the expirations and the inspirations.An respiratory rhythm can be described as regular or irregular.

14. Copyright © The McGraw-Hill Companies, Inc. Respiratory quality, usually breathing does not require noticeable effort. Dyspnea, difficult and labored breathing. Orthopnea, ability to breath only in upright sitting or standing positions.

15. Copyright © The McGraw-Hill Companies, Inc. Breath sounds - Stridor, harsh sound heard during inspiration with laryngeal obstruction - Stertor, snoring respiration usually due to a partial obstruction of the upper airway. - Wheeze, continuous, high pitched musical sound occurring on expiration when air moves through narrowed or partially obstructed air way.

16. Copyright © The McGraw-Hill Companies, Inc. Breath sounds - Stridor, harsh sound heard during inspiration with laryngeal obstruction - Stertor, snoring respiration usually due to a partial obstruction of the upper airway. - Wheeze, continuous, high pitched musical sound occurring on expiration when air moves through narrowed or partially obstructed air way.

17. Copyright © The McGraw-Hill Companies, Inc. Secretions and coughing - Hemoptysis, the presence of blood in the sputum - Productive cough, a cough accompanied by expectorated secretions - Nonproductive cough, a dry, harsh cough without secretions