Any tricks to taking the respirations

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I am in school for CNA, and doing clinicals right now at a nursing home, Is there any tricks to taking the respirations, I cant figure out whether to watch the stomach or chest. Thats is one part I am having trouble with.:bluecry1:

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Specializes in Geriatrics.
daisy007 said:
I am in school for CNA, and doing clinicals right now at a nursing home, Is there any tricks to taking the respirations, I cant figure out whether to watch the stomach or chest. Thats is one part I am having trouble with.:bluecry1:

I take radial pulse and resps at the same time...I watch the chest. It takes some time to learn how to get both at the same time but that is how I do it anyway.

Blessings, Michelle

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Thread split and moved to the CNA Discussion forum for more feedback.

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i count for 15 sec and multiply by four. I usually do this after I have counted the pulse but I don't let go of the wrist, alot of times i noticed if a patient notices you counting there resp they tend to get a little anxious and there resp speed up. If they dont'' know you are couting then they are at a resting rate

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daisy007 said:
I am in school for CNA, and doing clinicals right now at a nursing home, Is there any tricks to taking the respirations, I cant figure out whether to watch the stomach or chest. Thats is one part I am having trouble with.:bluecry1:

If taking respirations manually, two tricks are watching the shoulders rise and fall, and/or taking the arm that you are taking the pulse with and place it across the patient's chest. Hope this helps.

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Specializes in Med/Surg.

The easiest for me is to watch the stomach rise and fall. Sometimes it is hard to watch the person's chest. I think it depends on the person because some people push their stomach out more and others move their chest/shoulders more. You will just have to assess the situation when it comes about. But I would say either look at the chest/shoulders or stomach. I also just count for 15 seconds and multiply by 4.

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I watch the rise and fall of the clothing and if they arent wearing anything then their chest. I do it for 30 sec. 15 sec on pulse and 15 on reps then do the math.

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For your CNA class, I'd take the respirations for a full minute. I'd also watch for which ever you see rising better, chest or stomach. It's much easier that way.

What I do at work is I take respirations for 15 sec X 4. But if my patient is on respirations qh then I'd take @ lease 30 sec X 2, but if I have time then it's for the full minute. Usually they're on respirations qh due to medications they're on. Now, what you also want to do in that situation is to make sure you take the depth of the respirations too. That's something that you ALWAYS want to report to your nurse because some medications need to be held because of respirations.

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I'm finishing up my clinicals for my CNA class, and with them half over, I have to agree with my instructor - in a nursing home, take it for a full minute because most of the residents do not have a steady rate of respirations.

Also, we were taught to focus your eyes on a point just past the person (I usually look just past their shoulder, across their body - if that makes sense), so that you can peripherally see their clothing shift with each respiration. It's less invasive than laying their arm across their body for it - that would freak many of our residents out and they'd get agitated, but then, I'm on a primarily dementia area and little things set them off in the evening. I do respirations just after radial pulse, continuing to hold the wrist so that they don't realize I'm not just taking their pulse.

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Specializes in long term care...for now :).

If I can take a blood pressure using an automated machine, I usually count their resps while the machine pumps up and releases. I keep my hand on the cuff (but not too hard) until I finish counting. If I can't get it while doing blood pressure I keep my hand on their wrist after I take the pulse and just look past them and watch their chest or the top of their back (not directly at them; privacy issue IMO) and count pulse for one minute and respirations for 2 minutes to make sure it is accurate.

Terra J

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Specializes in Acute Care, Rehab, Palliative.

I hold the wrist and put one hand on their upper back. Count the pulse for minute and then count resps for one minute. You can feel their breathing movements with the hand on their back.Don't tell them what you are doing or they will alter their breathing.

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loriangel14 said:
I hold the wrist and put one hand on their upper back. Count the pulse for minute and then count resps for one minute. You can feel their breathing movements with the hand on their back.Don't tell them what you are doing or they will alter their breathing.

That is the correct method. In Florida you will fail your skills test if you do the 15 X 4 or 30 X2 method for pulse or respirations.

An irregular heart beat may not show up in 15 or 30 seconds and you would have missed something very important. Count (of course) respirations, but also listen to breath sounds apparent to the unaided ear.

Be thorough on your vitals! Never hurry or guesstimate!

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