Do you count resps every time you do vitals?

Nurses General Nursing

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  1. When do you count resps with vitals?

    • 142
      Every single time
    • 58
      Based on the diagnosis or medications given
    • 74
      I usually estimate, unless they are respiratory
    • 22
      I'll check them once, then estimate thereafter
    • 61
      I alternate between 16, 18, and 20, unless they look too slow or fast
    • 20
      truthfully, seldom
    • 18
      I always check them, and don't trust the CNAs to have really done them

240 members have participated

Tweety, BSN, RN

34,248 Posts

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
Honestly,there just isn't enough time in one shift to do everything strictly "by the book", especially in a nursing home setting where you have 30-40 patients at a time-not to mention that most are stable anyway. I voted for,

"based on medication or diagnosis".

Count for 15 seconds and multiply times four. That's all the time it takes.

I agree that there isn't time to do anything by the book. But when you document respirations, unless it says "estimated count" you're falsifying medical records by guessing what you think it is. The time it takes you to look at them and guess, you could actually get a true count.

prmenrs, RN

4,565 Posts

Specializes in NICU, Infection Control.

Babies: need to count @ least 30 seconds. If irregular, go for a full minute. Gently place your hand on the [sleeping, preferrably] baby's trunk, outside the blankets. Can't "feel" it? Slip your hand under some of the swaddling; watch head and neck @ same time; let the kid settle down--they'll squirm @ first and hold their breath--then count.

UM Review RN, ASN, RN

1 Article; 5,163 Posts

Specializes in Utilization Management.

I guess I must do it in my head at this point, because when I'm doing vitals and an assessment, I decide whether they're too fast or too slow.

Then I do a quick 15-sec count for all the normal-appearing folks, but I'll go to a full minute count for those who are outside of the range of 18-24.

I have also found people whose resps were 8 or 10 or as high as 40, and had been recorded as normal. But we need to remember that resps can change dramatically over the course of a couple of hours.

vamedic4, EMT-P

1,060 Posts

Specializes in Peds Cardiology,Peds Neuro,Pedi ER,PICU, IV Jedi.

With our patient population, you'd be completely stupid if you DIDN'T count them each time. We have some little one's who are fine with resps of 20, some with resps > 90. It's too important not too count...each time.

kimber1985

43 Posts

I always count for 30 secs for a well patient with regular breathing pattern, a full minute if they have any sort of irregular breathing. I just don't feel responsible with 15 X 4.

UM Review RN, ASN, RN

1 Article; 5,163 Posts

Specializes in Utilization Management.
With our patient population, you'd be completely stupid if you DIDN'T count them each time. We have some little one's who are fine with resps of 20, some with resps > 90. It's too important not too count...each time.

Vamedic, is that a typo??????

Lacie, BSN, RN

1,037 Posts

Specializes in jack of all trades.

I always count respirations during vitals! How difficult is it when your doing the pts pulse to go the extra while they are being still to do the respirations. After I count the pulse or heartrate by steth I continue to appear to do so while counting respirations as pt tend to hold still during that time and relaxed (at least those that are able to do so). If they think I'm listening to lung sounds, etc they tend to change the breathing pattern to "help" lol. I count when they dont know I'm doing so.

Sheri257

3,905 Posts

I've seen so many people NOT count respirations, it's ridiculous. Yes, I know there's not always enough time for everything but, when an entire floor of patients is supposedly at 20 it's absurd.

:typing

BlkQueenLPN

23 Posts

Specializes in MedSurg/Ped Vent/Geriatrics/Rehab.
Count for 15 seconds and multiply times four. That's all the time it takes.

I agree that there isn't time to do anything by the book. But when you document respirations, unless it says "estimated count" you're falsifying medical records by guessing what you think it is. The time it takes you to look at them and guess, you could actually get a true count.

Your kidding....

That's too cute.

jill48, ASN, RN

612 Posts

Specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.

Well of course! Your charting it so you better be doing it. :smokin:

Tweety, BSN, RN

34,248 Posts

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
Your kidding....

That's too cute.

No I'm not kidding. Don't patronize.

Like most experienced practioners I can look at someone and tell if they are tachypic or not. However, guessing someones respirations and then documenting it as a true factual count is at it's worst falsifying information. Besides "cute" what would you call it?

MOOSEMAN

38 Posts

Specializes in Peds,ER, Management, Critical Care.

If you document that you did vital, I can only hope that you truely did!!!!

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