RESPIRATORY ASSESSMENT
RESPIRATION

The
 Act
of breathing
 Exchange of oxygen and carbon dioxide from the air
into our lungs
1
inhalation + 1 exhalation = 1 respiration,
(complete breath)
RESPIRATORY RATE
Observe the clients chest movement for 1 min.
 In adults and older children observe chest
movements
 Children under 7 use abdominal movement
 Auscultation with a stethoscope is also a
method to asses respiratory rate

CHARACTERISTICS OF RESPIRATION
Rate, Rhythm and Quality
 Rate:

# of breaths per minute
 Adult rate = 12 – 20 breath per minute
 Respiratory rates (RR) decrease as a person increases
in size

 Who
will have a higher RR? A 7 year old or 100 year old?
 Who will have a higher RR a 100lb women or 200lb man?

Hypoventilation: decrease in rate

Caused by medication, decreased body temp, lack of
oxygen
CHARACTERISTICS OF RESPIRATION
Rate, Rhythm and Quality
 Rhythm:

 Pattern
should be regular.
 EX: of irregular: Cheyne-Stokes
 Shallow
breaths that go deeper and deeper
 Decrease to more shallow breaths
 Period of apnea
 Last from 5-40 seconds
CHARACTERISTICS OF RESPIRATION
Rate, Rhythm and Quality
 Quality:

 Seen
in volume and effort.
 Volume: amount of air taken into and exhaled from
lungs
 Documented
as shallow or deep breathing
 Effort:
amount of work the client uses in order the
breathe
 Client
uses other muscles in neck, chest, and abdomen
NORMAL LUNG SOUNDS
www.med.ucla.edu/wilkes/lungintro.htm
CRACKLE SOUND
Crackles (or rales) are caused by fluid in the
small airways
The popping sounds produced are created when air is forced
through respiratory passages that are narrowed by fluid,
mucus, or pus. Crackles are often associated with
inflammation or infection of the small bronchi, bronchioles, and
alveoli. Water logged alveoli
www.rale.ca/Crackles_a.htm
www.meddean.luc.edu/lumen/MedEd/medicine/
pulmonar/pd/step29e.htm (case 3)
WHEEZING SOUNDS
Wheezes are sounds that are heard continuously
during inspiration or expiration
They are caused by air moving through airways
narrowed by constriction or swelling of airway
or partial airway obstruction.
www.rale.ca/Wheezing_b.htm
STRIDOR LUNG SOUNDS
Stridor refers to a high-pitched harsh sound heard
during inspiration.
Stridor is caused by obstruction of the upper airway,
is a sign of respiratory distress and thus requires
immediate attention.
www.rale.ca/Stridor.htm
PLEURAL RUB SOUNDS
Pleural friction rubs are low-pitched, grating, or
creaking sounds that occur when inflamed pleural
surfaces rub together during respiration.
www.meddean.luc.edu/lumen/MedEd/medicine/pul
monar/pd/step29e.htm (case 2)
www.meddean.luc.edu/lumen/MedEd/medicine/pul
monar/pd/step29e.htm (case 9)
MORE LUNG SOUNDS….
www.meddean.luc.edu/lumen/MedEd/medicine/
pulmonar/pd/step29e.htm
STETHOSCOPE PLACEMENT