Copyright Goodheart-Willcox Co., Inc. Chapter 18 Vital Signs, Height, and Weight 471 What Is the Rate of Respiration? The rate of respiration is the measurement of a resident’s breathing cycle (inhalation followed by exhalation). Respiration rate helps determine a resident’s level of blood oxygenation, or how well oxygen is supplied to body cells. Respiration rate also helps determine if a resident is breathing in a normal range. This provides information about conditions such as asthma, heart disease, and even infections. Measuring Respirations To determine the rate of respiration, nursing assistants record the number of full breaths (each rise and fall of the chest) taken in one minute (Figure 18.22). Typically, this involves counting respirations for 15 seconds and multiplying the result by four. Some healthcare facilities require nursing assistants to count respirations for 30 seconds and then multiply the result by two. If respirations are irregular, the nursing assistant should count the number of full breaths for one full minute using a watch with a second hand. It is best to count respiration rate with no warning immediately after pulse is taken. This way, the resident is breathing as he or she normally would. After taking the pulse, switch to counting respirations without mentioning the change to the resident. A resident who knows his or her respirations are being counted may subconsciously alter his or her breathing, giving the nursing assistant an inaccurate result. Understanding Respiratory Rates A normal adult respiration rate is 12–20 breaths per minute. Infants and children breathe much faster. Infants can breathe from 30 to 60 breaths per minute, and children can breathe from 18 to 30 breaths per minute. Respiration can be affected by activity, anxiety, pain, fear, fever, infection, injury, and diseases of the heart and lungs. Observing how well a resident is breathing (regularity, expansion of the chest, and depth of respiration) is just as important as determining the rate (counting breaths). When counting respirations, also note the following: • Is the breathing regular or irregular? • Is the resident experiencing hyperventilation (deep, rapid breathing) or hypoventilation (slow, shallow breathing)? • Is the breathing rapid (called tachypnea), deep and labored (called dyspnea), or unusually slow (called bradypnea)? • Is the breathing noisy like snoring (called stertorous breathing)? • Are there periods of no breathing at all (called apnea)? Follow-Up 23. Wash your hands to ensure infection control. 24. Make sure the resident is comfortable and place the call light and personal items within reach. 25. Conduct a safety check before leaving the room. The room should be clean and free from clutter or spills. 26. Wash your hands or use hand sanitizer before leaving the room. Reporting and Documentation 27. Communicate any specific observations, complications, or unusual responses to the licensed nursing staff. Image courtesy of Wards Forest Media, LLC iStock.com/kali9 Figure 18.22 Counting respirations directly after taking pulse can help ensure the resident’s breathing is normal.