Respiration Assessment
Controlled by the respiratory center in the lateral medulla oblongata, respiration is the exchange of oxygen and carbon dioxide between the atmosphere and body cells. External respiration, or breathing, is accomplished by the diaphragm and chest muscles and delivers oxygen to the lower respiratory tract and alveoli.
Four measures of respiration—rate, rhythm, depth, and sound—reflect the body’s metabolic state, diaphragm and chest-muscle condition, and airway patency. Respiratory rate is recorded as the number of cycles (with cone cycle consisting of inspiration and expiration) per minute; rhythm, as the regularity of these cycles; depth, as the volume of air inhaled and exhaled with each respiration; and sound, as the audible digression from normal, effortless breathing.
The best time to assess your patient’s respirations is immediately after taking the pulse rate.
Equipment
Watch with second hand ▪ stethoscope, as needed ▪ alcohol pad.
Identifying Respiratory Patterns
The table below shows several common types of respiratory patterns and their possible causes. Assess the patient both for the underlying cause and for the effect on the patient.
| Type | Characteristics | Pattern | Possible Causes |
|---|---|---|---|
| Apnea | Periodic absence of breathing |  |
|
| Apneustic | Prolonged, gasping inspiration followed by extremely short, inefficient expiration |  |
|
| Bradypnea | Slow, regular respirations of equal depth |  |
|
| Cheyne-Stokes | Fast, deep respirations punctuated by periods of apnea lasting 20 to 60 seconds |  |
|
| Eupnea | Normal rate and rhythm |  |
|
| Kussmaul’s | Fast (over 20 breaths/minute), deep (resembling sighs), labored respirations without pause |  |
|
| Tachypnea | Rapid respirations; rate rises with body temperature at a rate of about four breaths/minute for every degree Fahrenheit above normal |  |
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Implementation
