Published Oct 12, 2012
strawberryluv, BSN, RN
768 Posts
I did my assessment yesterday on my patient and her newborn but while doing respiration I couldn't hear it well or the heart sounds made is hard to hear respiration.
I'm kind of worried about my midterm clinical evaluation I keep on giving inconsistent results when I do it with my instructor. I also have a hard time listening to the heart on a heavy patient...any tips?
Twinmom06, ASN, APN
1,171 Posts
for new borns they breathe so fast that you kind of have to tune out the heart tones...if you need to count the respirations without listening, I just count the # of times the umbilical cord clamp goes up and down LOL
classicdame, MSN, EdD
7,255 Posts
I had a hard time with this myself. You really need to practice to learn how to ignore one sound over another. The baby will not care if you listen over and over so practice
Katie71275
947 Posts
You really do just have to learn how to tone out the heart sounds. As for counting the resp, I like to place my hand on them and feel the movements so I can count b/c sometimes it's hard(esp if mom is holding them you can't see too well).
Thats what I was doing too! I was palpating the abdomen but my instructor insisted I listen to the breath sounds.
Needless to say we had a difference of opinion due to my poor hearing. I wonder if I will fail clinical because of this..
I plan on practicing on a baby mannequin next week....
Thanks for your awesome tips guys and I really like the one with just looking at the cord go up and down. Its
effective and I would do that too!
Wrench Party
823 Posts
I put my hand on them to feel the chest rise and fall, if that didn't work I would put them down in their bassinet
and count once, then count again to double check. I also had to put the baby in the bassinet a lot to count
HR, I found it almost impossible when mom was holding them.
emooski
4 Posts
I did my assessment yesterday on my patient and her newborn but while doing respiration I couldn't hear it well or the heart sounds made is hard to hear respiration.I'm kind of worried about my midterm clinical evaluation I keep on giving inconsistent results when I do it with my instructor. I also have a hard time listening to the heart on a heavy patient...any tips?
You have to tune everything else out. Once you hear it, follow it with your mind and ears. Concentrate, & you will find it. After that, it will be easy for you. If you cannot get it, tell them you just can't separate the two, never just guess. And about the heart sound on a heavy person, they will tell me to listen in a certain spot, but I never do. I find my own way to do things. If they have bigger chest, I usually go under and off to the side. Sometimes you just really have to "get in" there. Sounds odd, but it's the truth! You will get the hang of it!
metal_m0nk, BSN, RN
920 Posts
Babies are belly breathers. Place your hand lightly on their tummy and feel for rise and fall. Remember one breath = 1 rise and 1 fall.