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    Respiration Procedure

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    kuroko senpai
    The document discusses procedures for assessing respiration including preparing the client, observing respiratory rate, depth, rhythm and character, and relating findings to the client's condition. It provides purposes of assessment, items to assess, necessary equipment and steps to perform the procedure and evaluate findings.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Respiration Procedure

    Uploaded by

    kuroko senpai
    10 views2 pages
    The document discusses procedures for assessing respiration including preparing the client, observing respiratory rate, depth, rhythm and character, and relating findings to the client's condition. It provides purposes of assessment, items to assess, necessary equipment and steps to perform the procedure and evaluate findings.

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    Respiration-Procedure

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    The document discusses procedures for assessing respiration including preparing the client, observing respiratory rate, depth, rhythm and character, and relating findings to the client's condition. It provides purposes of assessment, items to assess, necessary equipment and steps to perform the procedure and evaluate findings.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    10 views2 pages

    Respiration Procedure

    Uploaded by

    kuroko senpai
    The document discusses procedures for assessing respiration including preparing the client, observing respiratory rate, depth, rhythm and character, and relating findings to the client's condition. It provides purposes of assessment, items to assess, necessary equipment and steps to perform the procedure and evaluate findings.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    MABINI COLLEGES

    Daet, Camarines Norte


    College of Nursing and Midwifery

    RESPIRATION

    PURPOSES :

    1. To acquire baseline data against which future measurements can be compared


    2. To monitor abnormal respirations and respiratory patterns and identify changes
    3. To monitor respirations before or after the administration of a general anesthetic or any
    medication that influences respirations
    4. To monitor clients at risk for respiratory alterations (e.g., those with fever, pain, acute
    anxiety, chronic obstructive pulmonary disease, asthma, respiratory infection, pulmonary
    edema or emboli, chest trauma or constriction, brainstem injury)

    ASSESSMENT, Assess

    1. Skin and mucous membrane color (e.g., cyanosis or pallor)


    2. Position assumed for breathing (e.g., use of orthopneic position)
    3. Signs of lack of oxygen to the brain (e.g., irritability, restlessness, drowsiness, or loss of
    consciousness)
    4. Chest movements (e.g., retractions between the ribs or above or below the sternum)
    5. Activity tolerance , Chest pain , Dyspnea , Medications affecting respiratory rate

    Equipment.

    Clock or watch with a sweep second hand or digital seconds indicator

    PROCEDURE RATIONALE
    IMPLEMENTATION
    Preparation For a routine assessment of respirations,. A client who has been
    1. Determine the client’s activity schedule and choose a suitable time exercising will need to rest
    to monitor the respirations. for a few minutes to
    permit the accelerated
    respiratory rate to return
    to normal
    Performance
    1. Introduce self and verify the client’s identity using agency To establish rapport .
    protocol.

    2. Explain to the client what you are going to do, why it is To lessen fear and anxiety.
    necessary, and how he or she can participate. Discuss how the
    results will be used in planning further care or treatments
    3. Perform hand hygiene and observe appropriate infection To prevent the spread of
    prevention procedures. infection.
    . 3. Provide for client privacy. To promote comfort.
    4. Observe or palpate and count the respiratory rate.
    • The client’s awareness that the nurse is counting the respiratory
    rate could cause the client to purposefully alter the respiratory
    pattern.
     If you anticipate this, place a hand against the client’s
    chest to feel the chest movements with breathing, or
    place the client’s arm across the chest and observe the

    RespirationProcedure By: Nomelita S. Lo


    Page 1
    chest movements while supposedly taking the radial
    pulse.
     Count the respiratory rate for 30 seconds if the
    respirations are regular
     Count for 60 seconds if they are irregular. An inhalation
    and an exhalation count as one respiration
    5. Observe the depth, rhythm, and character of Rationale: During deep
    respirations. respirations, a large
    Observe the respirations for depth by watching the volume of air is exchanged;
    movement of the chest.. during shallow
    respirations, a small
    volume is exchanged
    .

    6. Observe the respirations for regular or irregular rhythm Rationale: Normally,


    respirations are evenly
    spaced.

    7. Observe the character of respirations—the sound they Rationale: Normally,


    produce and the effort they require. respirations are silent and
    effortless
    8. Document the respiratory rate, depth, rhythm, and character
    on the appropriate record (see ❶ in Skill 29–1).

    EVALUATION
    9. Relate respiratory rate to other vital signs, in particular pulse
    rate; relate respiratory rhythm and depth to baseline data and
    health status
    10. Report to the primary care provider a respiratory rate
    significantly above or below the normal range and any notable
    change in respirations from previous assessments; irregular
    respiratory rhythm; inadequate respiratory depth; abnormal
    character of breathing—orthopnea, wheezing, stridor, or
    bubbling; and any complaints of dyspnea.

    RespirationProcedure By: Nomelita S. Lo


    Page 2

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