Quote from keishapound
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:
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