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Vital Signs in the Ambulatory Setting: An Evidence-Based Approach Cecelia L. Crawford, RN, MSN. How to Measure Respirations. Respiration Measurement - An Overview. Equipment for accurate respiratory measurement Watch or clock with second hand or digital second counter Stethoscope

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vital signs in the ambulatory setting an evidence based approach cecelia l crawford rn msn

Vital Signs in the Ambulatory Setting:An Evidence-Based ApproachCecelia L. Crawford, RN, MSN

How to Measure Respirations

respiration measurement an overview
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
respirations it s all about the numbers
Respirations – It’s All About The Numbers!

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)

respiratory rate procedure
Respiratory Rate Procedure
  • Wash hands & put on gloves, if appropriate
  • Provide privacy
  • Assist patient to a comfortable & relaxed position
respiratory rate procedure5
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

respiratory rate procedure6
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
normal respiratory rates
Normal Respiratory Rates

(Mosby’s Critical Care Nursing Reference, 2002; Perry & Potter, 2006)

respiratory rate
Respiratory Rate

9. Pediatric patients

  • If panting, use stethoscope to count
  • Agitation can result in inaccurate RR
respiratory rate procedure9
Respiratory Rate Procedure

Respiratory rates are NOT a reliable way to determine low oxygen levels!

  • RN and MD assessment is needed
respiratory rate procedure10
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
respiratory rate procedure11
Respiratory Rate Procedure

11. Discuss respiratory rate with patient or parent

12. Remove gloves & wash hands

respiratory rate procedure12
Respiratory Rate Procedure

13. Document the Results

  • Flowsheet, clinic record, or clinic chart

14. Communicate the Results

  • RN
  • MD
respiratory measurement in the clinic
Respiratory Measurement in the Clinic
  • YOU can make the difference:
    • Welcoming presence
    • Decrease any anxieties & fears
    • Reassure patients & family
    • Accurate vital signs