Understanding Breathing

Common Therminology

Term	Meaning
Aerobic	With oxygen
Anaerobic	Without oxygen
Anoxia	No oxygen reaching the brain
Apnoea	Absence of breathing
Apnoeustic breathing	Prolonged gasping inspiration and short inefficient expiration
Asthmatic breathing	Difficulty on expiration with an audible expiratory wheeze. Caused by spasm of the respiratory passages and partial blockage by increased mucus secretion
Biot’s respirations	Periods of hyperpnoea occurring in normal respiration. Sometimes seen in clients with meningitis
Bradypnoea	Slow but regular breathing. Normal in sleep but may be a sign of opiate use, alcohol indulgence or brain tumour
Cheyne-Stokes respirations	Gradual cycle of increased rate and depth followed by gradual decrease with the pattern repeating every 45 seconds to three minutes. Also associated with periods of apnoea, particularly in the dying
Cyanosis	A bluish appearance of the skin and mucous membranes caused by inadequate oxygenation
Dyspnoea	Difficulty breathing
Expiration	The act of breathing out
Haemoptysis	Blood in the sputum
Homeostasis	The automatic self-regulation of man to maintain the normal state of the body under a variety of environmental conditions
Hypercapnia	High partial pressure of carbon dioxide
Hyperpnoea	Deep breathing with marked use of abdominal muscles
Hyperventilation	Increased rate and depth of breathing
Hypoventilation	Irregular, slow, shallow breathing
Hypoxia	A lack of oxygen concentration
Hypoxaemia	A lack of oxygen in the blood
Inspiration	The act of breathing in
Kussmaul’s respirations	Increased respiratory rate (above 20 rpm), increased depth, panting laboured breathing. Causes include diabetic ketoacidosis and renal failure
Orthopnoea	The ability to breath easily only when in an upright position
Perfusion	The flow of oxygenated blood to the tissues
Stridor	A harsh, vibrating, shrill sound produced during  respiration. Usually indicates an obstruction
Tachypnoea	Increased rate of breathing
Tracheostomy	Making of an opening into the trachea or windpipe
Ventilation	The movement of air in and out of the lungs

                                                           

Monitoring respiratory rate

Monitoring a client’s respiration rate is essential to facilitate the evaluation of medical treatment and nursing interventions.

 Equipment

ü  A digital watch or watch with a second hand, together with an appropriate chart for recording, is required.

ü  The procedures and rationales are given below.

Procedure	Rational
Explain procedure and ensure adequate understanding	Promote client co-operation and obtain informed consent, though this step is often omitted where there is a danger that the person may voluntarily control their breathing and thus alter the rate
Count respirations as chest rises and falls for a period of one minute	To monitor rate and compare to normal values 1.      New-born: 30–80 rpm 2.      Early childhood: 20–40 rpm 3.      Late childhood: 15–25 rpm 4.      Adult male: 14–18 rpm 5.      Adult female: 16–20 rpm Pulse-to-respiration ratio = 5:1
Observe depth of respirations	To monitor depth and compare to norm – usually shallow and effortless
Listen for breath sounds, e.g. stridor, wheeze, rub, rattle	To monitor sounds and compare to norm –usually almost inaudible
Observe pattern of breathing and use of accessory muscles	To monitor pattern and compare to norm – usually effortless
Observe colour of skin/mucous membranes, e.g. pallor, cyanosis	To ensure that adequate oxygen is getting to the tissues (i.e. tissue perfusion)
Record rate on appropriate chart and report any abnormalities	Legal requirement to maintain documentation and safeguard client through good communications

Refferences

Mills, Elizabeth Jacqueline. 2004. Nursing Procedures, 4^th Edition. USA : Lippincott

Penelope Ann Hilton.2004.Fundmental OF Nursing Skill. London : Whurr Publishers

Temple, Jean Smith and Johnson, Joyce Young. 2006. Nurse’s Guide To Clinical  Procedure, 5^th Ed.  USA : Lippincott