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

This question is to find out how many nurses actually count resps every single time they take vitals.

When I work in the cicu, I set my monitor to show the resp parameter. When I am working in the surgical unit, the CNA's routinely take vitals. If I do a set I do usually count resps. I wouldn't ever make up a number though. If I don't count, I just don't chart a RR for that set of vitals. If the pt is in resp distress, or I have any reason to be suspicious, i count resps.

Specializes in L&D.
when i worked icu, i would verify with my first assessement the the monitor was accuratly reflecting their resp count. after that, i wouldn't cout myself, just look at the monitor, unless something changed. if they were on the vent, sometimes i would use the count the vent had. just depended on the situation.

this is what i do too. i count for myself every 4 hours but in between i will trust the vent if it appears to correlate with my count. on non-vented patients i count for 15 seconds and multiply by 4, every time. if a patient's rr is really high or really low on a vent i will also count for myself to verify.

Specializes in ICU, telemetry, LTAC.

Our respiratory rate on our datascope monitors is the one thing most likely to be wrong. It uses the red lead, I think, to get a rate but if the planets aren't aligned just right and the sticker isn't really fresh, and if I don't hold my mouth just right it will read anywhere from five to fifty and be nowhere near reality.

So I do a lot more counting in ICU than I ever did in tele. On the floor it was 15 sec x4 and done, now I gotta really pay attention to it so I can chart that I know it's X when the monitor records Y. I won't chart that the equipment is inaccurate unless I know for a fact that it is. Besides, most of the low readings are on people breathing really shallow and those are overdoses not on the vent- yet. Gotta watch em! Can't automatically assume the one with 40's readings is faulty either, it may be someone in trouble, even if they weren't earlier.

Don't assume no one pays attention to what you chart either. We have some very thorough docs who read the graphics, read my admission assessments, look at my flowsheets for trends, and double check my math on the fluid balance in their heads. So if the datascope printout shows trends of stuff that's dangerous and it wasnt accurate, I better have a readily accessed explanation for 'em. Look at it like this: when it goes in the chart you're swearing on your license that it's the truth. Do you want anything less?

Edit: I forgot that with the vented patients there is another whole machine that counts resps and does quite a bit more accurate job than the datascope.

It only makes sense, it is not hard

I had a patient for the CPNE this weekend on heavy doses of opioids. She was drowsy and soporific and everyone had all of her resps at 20. I got 11 twice and notified her nurse.

I certainly always count the first time I assess someone and every single time if there is any reason at all to suspect that their breathing could be off.

Specializes in ICU, telemetry, LTAC.

Ahh... you said soporific... That always makes me smile. I think of the flopsy bunnies eating too much lettuce. :-)

I think where you see repetitive numbers are when individuals only count the respirations over 10 seconds and multiply. In 10 seconds most people only breathe 3, 4, or 5 times and this would reflect certain caregivers charting their patients only seem to have respirations of 12, 16, or 20. If you counted the patient for he proper minute of course the tally is almost always different. Of course dependent on condition is when I take vitals but I always make sure on respiration to take full complete sets q4h. When viewing my patient from the station or charting areas I will reassess this occasionally as chest rise in most patients is easy to see from a distance. Just my two cents.

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