Respiratory Rate and Breath Sounds Flashcards
Respiratory Rate (RR) Norms
- Newborns - 25-50
- Adults - 12-20
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
FYI
RR- You will want to note 4 things
- Rate
- Depth
- Rhythm
- vesicular breath sounds
Rate
respirations/minute or RR
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)
Depth
The regularity of inspirations and expirations. Normally there is an even time interval between respirations described. Rhythm is described as regular or irregular.
Rhythm
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.
vesicular, adventitious
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
Procedure for Monitoring RR
Normally heard during inspiration and the first 1/3 of expiration
Heard throughout most of the lung fields BK
Normal Vesicular Breath Sounds
- 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
Normal Bronchial Breath Sounds
- 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
Normal Bronchovesicular Breath Sounds
Crackles or Rales
Wheeze
Stridor
Adventitious (Abnormal)Breath Sounds
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
Crackles or Rales
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.
Subcutaneous Emphysema
- 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
Wheezes
