RESPIRATORY RATE
STEPS RATIONALE
1. Perform hand hygiene. Draw curtain around
bed and/or close door.
2. Be sure that patient is in comfortable position,
3. Place patient's arm in relaxed position across
abdomen or lower chest or place your hand
directly over patient's upper abdomen.
4. Observe complete respiratory cycle (one
inspiration and one expiration).
5. After observing a cycle, look at second hand of
watch and begin to count rate; when sweep hand
hits number on dial, begin time frame, counting
one with first full respiratory cycle.
6. If rhythm is regular, count number of
respirations in 30 seconds and multiply by 2. If
rhythm is irregular, less than 12, or greater than
20, count for 1 full minute.
7. Note depth of respirations subjectively
assessed by observing degree of chest wall
movement while counting rate. You also
objectively assess depth by palpating chest wall
excursion or auscultating posterior thorax after
rate has been counted (see Chapter 31).
Describe depth as shallow, normal, or deep.
preferably sitting or lying with head of bed
elevated 45 to 60 degrees. Be sure that patient s
chest is visible. If necessary, move bed linen or
gown.
Prevents transmission of microorganisms.
Maintains privacy.
Sitting erect promotes full ventilatory movement.
Ensures clear view of chest wall and abdominal
movements
A similar position used during pulse assessment
allows respiratory rate assess. ment to be
inconspicuous. Patient's hand or your hand rises
and falls during respiratory cycle.
Rate is accurately determined only after you have
observed a respiratory cycle.
Timing begins with count of one. Respirations
occur more slowly than pulse; thus timing does
not begin with zero.
Respiratory rate is equivalent to number of
respirations per minute. Suspecte irregularities
require assessment for at least 1 minute (see
Table 30-6),
Character of ventilatory movement reveals
specific disease states that restri volume of air
from moving into and out of the lungs.
.
8. Note rhythm of ventilatory cycle Normal Character of ventilations reveals specific types of
breathing is regular and uninter-rupted. Do not alterations. Periodically people unconsciously
confuse sighing with abnormal rhythm. take single deep breaths or sighs to expand small
airways prone to collapse.

9. Observe for any increased effort to inhale and Patients with chronic lung disease may
exhale. Ask patient to describe subjective experience difficulty breathing all the time and
experience of breathing compared with usual can best describe their own discomfort from
breathing pattern. shortness of breath.

10. Replace bed linen and patient's gown. Restores comfort and promotes sense of well-
being.

11. Perform hand hygiene. Reduces transmission of microorganisms.

12. Discuss findings with patient as needed. Promotes participation in care and understanding
of health status.