CENTRAL LUZON DOCTORS’ HOSPITAL - EDUCATIONAL

INSTITUTION, INC
Romulo Highway, San Pablo, Tarlac City
Tel No. (045) 982-5019/982-5052/982-0264 Fax No. (045) 982-0780/982-2757

NURSING DEPARTMENT

CHECKLIST ON NURSING PROCEDURES (NCM _______)

___________Semester, A.Y. _____________

VITAL SIGNS
ASSESSING THE RESPIRATION

Name of Student: Date:

RATING SCALE:
1 - NO
2 - YES
3 - MASTERED

GRADING SYSTEM: Raw Score / Total Score x 50 + 50

Performed
Preparation NO YES Mastered Comments
1. Assess:
● Skin and mucous membrane
● color
● Position assumed for breathing
● Signs of cerebral anoxia
● Chest movement
● Activity tolerance
● Chest pain
● Dyspnea
● Medications affecting respiratory
rate
2. Assemble equipment and supplies:
● Watch with a second hand or
● indicator
Procedure
1. Explain to the client what you are
going to do, why it is necessary, and
how he can cooperate.
2. Wash hands and observe other
appropriate infection control
procedures.
3. Provide for client privacy.
4. Observe or palpate and count the
respiratory rate.
● If you anticipate the client’s
awareness of respiratory assessment,
place a hand against the client's chest
to feel the chest movements with
breathing, or place the client's arm
across the chest and observe the chest
movements while supposedly taking
the radial pulse.
● Count the respiratory rate for 30
seconds if the respirations are regular.
Count for 60 seconds if they are
irregular. An inhalation and an
exhalation count as one respiration.
5. Observe the depth, rhythm, and
character of respirations.
● Observe the respirations for depth by
watching the movement of the chest.
● Observe the respirations for regular or
irregular rhythm.
● Observe the character of
respirations—the sound they produce
and the effort they require.

6. Document the respiratory rate,

depth, rhythm, and character on
the appropriate record.

RAW SCORE -
-
TOTAL SCORE

FINAL GRADE -