Published Apr 2, 2005
keishapound
67 Posts
Hello all I am a second semester ADN student who needs some advice on counting respirations. I know that you should listen for 1 full minute but what I have trouble with is counting these without the patient being aware that I am doing so. Also what is a good way to get a quick head toe assessment and do incorporate respirations at the same time without having to go back inside the patient's room several times :uhoh21:
JonathanRN
26 Posts
I tell them I need to take their pulse and they usually relax while I count their respirations. This works great for me.
thanks
z's playa
2,056 Posts
I do their pulse for 30 secs....times it by 2 (unless it seems off, in which case I go for a full minute) then I pretend to still do their pulse but I'm really doing their respirations. This way they think I'm doing their pulse the whole time and breathe easy. :)
madwife2002, BSN, RN
26 Articles; 4,777 Posts
I find that if you stand at the end of the bed pretending to look in the patients file, you can count without being too obvious to the patient.
Sneaky but clever thanks
PickMePlze
113 Posts
I have a related question, not trying to hijack your thread or anything:) How do you count respirations with the patient is wearing a loose fitting gown? I've had patients wearing rather loose clothing and it was near impossible to count respirations. Oh, in case this sounds like a dumb question, I'm a 1st semester student.:rotfl:
RRN
108 Posts
Try lying their arm across their chest.. Then you can feel the rise and fall of their respirations as you count their pulse.
RRT/RN
27 Posts
You can also count resps the same time you listen to lung sounds or heart sounds. You've already go the steth to your ears. I listen for 15 seconds and multipy x4.
BunnyRN
158 Posts
If you tell the patient/client that you're going to count their respirations, wouldn't they be tempted to control their breathing pattern? Leaving you with a false respiration rate...
It's best to pretend as if you are taking their radial pulse and glance at their chest.
DON'T MAKE OBVIOUS!!!:)
Laurlaur
44 Posts
I would say it is more important to monitor resp rate if the patient is in obvious resp. distress, or some sort of respiratory problem. If they are a good colour (well perfused), not cyanosed and can hold a conversation (not breathless etc) and temp and pulse are normal then maybe not as vital to get an exact full minute count.....although resp. rate is important look at other things too...
Nrs_angie, BSN, RN
163 Posts
Hi Keisha,
At my school they taught us from the beginning, to count resps while you are taking the pulse. You count the pulse for 30 (unless it is irreg of course), then you go right into counting the resps for another 30 seconds, while you are still holding the patient's arm. That way they do not know it and will not consciously alter their breathing pattern. That is just the way we were taught and I assumed everyone was taught the same. Works great for us. As for the best way to do a quick good head to toe assessment... That takes practice to be "good". But if you want quick, without having to keep going back in the room... then do it while you are doing their bath. My method is I usually try to do everything on the front of their body first. Such as apical pulse, bowel sounds, capillary refill, peripheral pulses, any edema, ect. While you are washing them, you can assess their skin for incisions, wounds, ulcers, ect. Once you are ready to wash their back... that is when you can listen to lung sounds. That way they won't have to roll or be rolled several times, unneccessarily. Then at this time, you can also assess their skin on the back side of their body for lesions, ulcers, wounds, ect, ect. All the while you are washing them, you can ask if they have nausea/vommiting, pain, BM's, itching, cough, ect. I know that not all nursing students must do bathes, but if you do... this is the quickest way I have found. :) Hope this helps! Let me know. Good luck to you, angie