Respirations_VitalSigns_COCCC.ppt
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Cecelia L. Crawford provides guidance on accurately measuring respiratory rate in an ambulatory care setting. She outlines the necessary equipment, patient positioning, and procedural steps to obtain a respiratory rate measurement. These include allowing time for the patient to relax, counting for a full minute, and being aware of potential biases. Normal respiratory rate ranges are provided for different age groups. Communicating accurate results to nurses and doctors is emphasized.
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- "Tell me about your health concerns."
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Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
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"Roll up your sleeve, please. I will examine your chest now."
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- Observe chest wall movement with breathing
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- Palpate chest wall for tenderness, masses
- Palpate trachea and note any deviation
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- Auscultate anterior and posterior chest
- Note breath sounds (vesicular, bronchial, decreased)
- Note added sounds (crackles, wheezes, rubs)
- Auscultate heart sounds (S1, S2, murmurs)
ASSESSMENT : PHYSICAL EXAMINATION
"Roll up your sleeve, please. I will examine your chest now."
Inspection
- Note chest shape, symmetry, scars
- Observe chest wall movement with breathing
Palpation
- Palpate chest wall for tenderness, masses
- Palpate trachea and note any deviation
Percussion
- Percuss chest areas to note any dullness/hyperresonance
Auscultation
- Auscultate anterior and posterior chest with diaphragm of stethoscope
- Note breath sounds (vesicular, bronchial, decreased)
- Auscultate heart sounds and note any abnormalities
- Auscultate carotid arteries and note any br
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2-Essential-Symptoms-Signs-_-May-2017.pdf
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- 1. Presentation title SUB TITLE HERE Vital Signs in the Ambulatory Setting: An Evidence-Based Approach Cecelia L. Crawford, RN, MSN How to Measure Respirations
- 2. Respiration Measurement - An Overview • Equipment for accurate respiratory measurement Watch or clock with second hand or digital second counter Stethoscope Pen or pencil Flowsheet, chart, or medical record Clean hands and fingers! • Patient in a comfortable & relaxed position • Waited 5 minutes if patient was active • Enough time to count the respiratory rate
- 3. Terminal Digit Preference • Some people may show a preference for certain numbers in respiratory rate readings* Zeros, even numbers, odd numbers • Be aware you might “like” certain numbers more than others! (*Roubsanthisuk, W., Wongsurin, U., Saravich, S., & Buranakitjaroen, P., 2007) Respirations – It’s All About The Numbers!
- 4. Respiratory Rate Procedure 1. Wash hands & put on gloves, if appropriate 2. Provide privacy 3. Assist patient to a comfortable & relaxed position
- 5. Respiratory Rate Procedure 4. Position patient for clear view of chest movement 5. Place patient’s arm or your own hand in a relaxed position across stomach or lower chest 6. Observe a complete respiratory cycle An inhale and an exhale http://www.lane.k12.or.us/CSD/CAM/level1/ASSESS
- 6. Respiratory Rate Procedure 7. Count for 60 sec Full minute count for: Children Irregular respirations Very fast or very slow respirations 8. Count for 30 sec and multiply X2 Shorter time counts = inaccurate data
- 7. Normal Respiratory Rates AGE BREATHS/MIN Newborn to 6 weeks 30 - 60 Infant (6 weeks to 6 months) 25 - 40 Toddler ( 1 to 3 years) 20 - 30 Young Children ( 3 to 6 years) 20 - 25 Older Children (10 to 14 years) 15 - 20 Adults 12 - 20 (Mosby’s Critical Care Nursing Reference, 2002; Perry & Potter, 2006)
- 8. Respiratory Rate 9. Pediatric patients If panting, use stethoscope to count Agitation can result in inaccurate RR
- 9. Respiratory Rate Procedure Respiratory rates are NOT a reliable way to determine low oxygen levels! RN and MD assessment is needed
- 10. Respiratory Rate Procedure 10. Inform the RN or MD for: Difficult to count respirations Very fast or very slow breathing Irregular breathing If patient seems to be having trouble breathing
- 11. Respiratory Rate Procedure 11. Discuss respiratory rate with patient or parent 12. Remove gloves & wash hands
- 12. Respiratory Rate Procedure 13. Document the Results Flowsheet, clinic record, or clinic chart 14. Communicate the Results RN MD
- 13. Respiratory Measurement in the Clinic • YOU can make the difference: Welcoming presence Decrease any anxieties & fears Reassure patients & family Accurate vital signs