Respiratory Rate and Breath Sounds

Question 1

Respiratory Rate (RR) Norms

Answer 1

• Newborns - 25-50

- Adults - 12-20

Question 2

FYI -RR decreases as we age due to decreased elasticity of the lungs and decreased efficiency of gas exchange. Therefore, usually the elderly have the lowest RR RED

Answer 2

FYI

Question 3

RR- You will want to note 4 things

Answer 3

• Rate
• Depth
• Rhythm
• vesicular breath sounds

Question 4

Rate

Answer 4

respirations/minute or RR

Question 5

The amount of air exchanged with each breath. This should be consistent, producing even, uniform chest movement. When abnormal, it can be described as deep (greater than normal) or shallow (less than normal)

Answer 5

Depth

Question 6

The regularity of inspirations and expirations. Normally there is an even time interval between respirations described. Rhythm is described as regular or irregular.

Answer 6

Rhythm

Question 7

Sound refers to deviations from normal, quiet, effortless breathing and requires close listening (auscultation). Normal sound is called_________ breath sounds while abnormal are called _____________ breath sounds.

Answer 7

vesicular, adventitious

Question 8

There are no contraindications for this procedure.
1-Make sure you have a watch or clock available
2-Wash hands
3-Expose the chest area if possible
4-Position your patient comfortably in supine or seated position
5-Ensure that your patient has been resting for 5 minutes or more
6-As the patient breathes, observe the rise and fall of the chest at the apex of the lung (normal is effortless and silent). You may even place your hand on the apex to feel the respirations at the same time.
7-Observe the rhythm, is it regular or irregular
8-Observe the depth, is it normal, deep or shallow
9-Take the respiration rate for 30 seconds and multiply by two. If the respirations are abnormal, observe the rate for a full minute to increase accuracy.
10-If indicated, determine the sound of breathing using a stethoscope

Answer 8

Procedure for Monitoring RR

Question 9

Normally heard during inspiration and the first 1/3 of expiration
Heard throughout most of the lung fields BK

Answer 9

Normal Vesicular Breath Sounds

Question 10

• Louder and higher in pitchBK
• The expiratory sound lasts longer than the inspiratory sound BK
• Usually heard in anterior lung fields, over the manubrium, if you can hear them at all RED
• A silent gap separates the inspiration sound from the expiration sound BK

Answer 10

Normal Bronchial Breath Sounds

Question 11

• Inspiratory and expiratory sounds are about equal in duration. RED
• The intensity of the expiratory sound is very loud and the pitch is very high. BK
• These can be heard over the trachea in the neck.BK

Answer 11

Normal Bronchovesicular Breath Sounds

Question 12

Crackles or Rales
Wheeze
Stridor

Answer 12

Adventitious (Abnormal)Breath Sounds

Question 13

Non-musical intermittent adventitious sound
Rattling or bubbling sounds that occur due to secretions in the air passages of the respiratory tract.
Chest hair can give a false crackle/rales sound

Answer 13

Crackles or Rales

Question 14

Is caused by air in tissue.
You can listen for it (crackling sound in stethoscope), but you can also feel it.
It feels like little rice krispies, and causes a crackling.

Answer 14

Subcutaneous Emphysema

Question 15

• Musical continuous adventitious sound RED
• High pitched continuous whistling sound produced by air passing through a narrowed airway such as a bronchi or bronchiole. RED
• It can be heard on inspiration or expiration but is more prominent on expiration. Symptom of asthma, CHF, Cystic fibrosis, emphysema, chronic bronchitis, and airway obstruction BK

Answer 15

Wheezes

Question 16

A harsh, high pitched crowing sound that occurs with upper airway obstructions resulting in narrowing of the glottis or trachea.
It is apparent in patients with tracheal stenosis or presence of a foreign object.

Answer 16

Stridor

Question 17

• Drawing of minimal breath into the lungs, usually by drawing air into the chest area using the intercostals muscles rather than throughout the lungs via the diaphragm RED
• Often seen in conditions including various anxiety disorders, asthma, hyperventilation, pneumonia, pulmonary edema, and shock. BK

Answer 17

Costal or Thoracic Breathing