Respiration

Question 1

Define respiration

Answer 1

Skills for midwifery practice states that respiration is where the body gains oxygen (inspiration) and excretes carbon dioxide (expiration)

Question 2

What is the normal rate for an adult?

Answer 2

12-20bpm

Question 3

What is the average rate for the newborn?

Answer 3

30-60bpm

Question 4

What shoukd normal breathing be like?

Answer 4

Should be effortless, automatic, regular and almost silent

Question 5

What are the indicators of respiration?

Answer 5

As part of baseline observations
Whenever other vital signs are recorded when completing MEOWS chart
Admission to hospital (especially with respiratory complaint)
Prior to commencing rescusitation
Any signs of altered breathing pattern
After recovery from anaesthesia (NICE 2011)

Question 6

What do we look for when observing respiration?

Answer 6

Observation of rate per minute
Depth
Associated signs (colour)
Regularity

Question 7

When would we observe respiration in the newborn?

Answer 7

At birth as part of the APGAR score
Whenever vital signs are being recorded
Maternal prolonged rupture of membranes
During resuscitation

Question 8

What factors can influence respiration?

Answer 8

High altitude 
Exercise 
Pain
Fever 
Infection

Question 9

What is the word for increased respiration rate?

Answer 9

Tachypnoea

More than 20bpm

Question 10

When might tachypnoea occur?

Answer 10

When in pain
exercise
fear
fever

Question 11

What is the word for decreased respiration rate?

Answer 11

Bradypnoea

Below 12bpm

Question 12

What term means shortness of breath lying down?

Answer 12

Orthopnoea

Question 13

What term means difficulty breathing or shortness of breath?

Answer 13

Dysopnoea

Question 14

What term is meant for temporary cessation of breath?

Answer 14

Apnoea

Question 15

What is hyperventilation?

Answer 15

Increase in rate and depth

Question 16

What changes occur in pregnancy?

Answer 16

Oxygen demands are higher
Breathing is diaphragmatic
Preogesterone relaxes smooth muscle of the alveoli so breaths are deeper

Question 17

What happens during labour?

Answer 17

Number and strength of contractions affect the pattern and depth of breaths
Must discourage breath holding- deep breathing during contractions in order to maintain oxygenation

Question 18

Explain the procedure when observing a woman’s respirations

Answer 18

1. Informed consent will make the woman aware of their breathing and therefore affect findings
2. Carry out while doing the pulse so woman is unaware
3. Wash hands in front of woman
4. Count chest wall movements for 60 seconds
5. Wash hands
6. Record findings in line with the NMC code
7. Discuss findings with mother