1. Vital Signs Respirations

2. Be Professional

3. Breathing Patterns

5. Abnormal Breathing

6. Cheyne-Stokes respirations • Respiratory pattern characterized by periods of respirations during which breathing starts shallow and gets progressively deeper, and then gets progressively shallower, followed by periods of apnea that can last up to 30 seconds or longer, then the cycle starts over. Each cycle can take anywhere between 30 seconds and 2 minutes or longer.

7. Kussmaul’s respirations • A type of labored or hyperventilation characterized by a consistently deep and rapid respiratory pattern. • This type of labored hyperventilation is usually seen in the late stages of a severe metabolic acidosis such as diabetic ketoacidosis. The patient becomes very “air-hungry” and the desperate gasping characteristic of Kussmaul’s breathing almost appears involuntary

8. Respiration A. Each breath includes inspiration and expiration. B. Measure by observing chest rise and fall.

9. Measure C. Measured in breaths per minute. D. Normal range = 12-24 breaths per minute. E. > than 24 = tachypnea – if breathing in great depth then called hyperpnea F. < than 12 = bradypnea G. Difficulty in breathing is called dyspnea

10. http://en.wikipedia.org/wiki/Wheeze • http://en.wikipedia.org/wiki/Stridor • http://en.wikipedia.org/wiki/Rales • http://www.easyauscultation.com/cases-waveform.aspx?CourseCaseOrder=7&CourseID=201 • http://www.easyauscultation.com/cases-waveform.aspx?CourseCaseOrder=3&CourseID=201

11. Quality of breathing H. Quality of breathing is determined as well as the rate of breathing 1. Depth 2. Clarity of breath sounds 3. Pain with breathing 4. Difficulty breathing – use of accessory muscles – sternocleidomastoidand intercostal muscles

12. How to Measure respirations • http://www.youtube.com/watch?v=8gbu09MXVSo

13. Procedure for taking TPRs a. When taking the pulse and respiration, do not drop the wrist until both the pulse and respiration are taken. This way the person does not know when his/her respirations are being measured – insuring a more accurate measurement.

14. Charting • Chart immediately • Graph according to policy • Chart Quality of respirations if abnormal C. Chart in order of TPR D. Do not write T =, P =, etc., simply: v/s 98.6 – 84 – 22.

15. The End