Respiratory Patterns

Respiratory assessment is more than counting breaths. Rate, depth, rhythm, effort, and effectiveness must be interpreted together because a fast rate can represent compensation, distress, pain, fever, anxiety, or failing ventilation. Normal resting rates vary with age: - Newborn to 1 year: 30–60 breaths/min - 1–6 years: 22–40 breaths/min - 7–11 years: 18–30 breaths/min - 12–17 years: 12–22 breaths/min - Adults: 10–20 breaths/min Count a full minute when the rhythm is irregular, and compare the result with the patient’s baseline and clinical context. A rate just above the adult range in a febrile patient is not interpreted in the same way as a sudden rate of 32 in a previously stable patient with chest tightness. Tachypnea is an abnormally rapid rate. It often appears early when the body is trying to increase gas exchange, but rapid, shallow breaths may increase the rate without moving enough air into the alveoli. Bradypnea is unusually slow breathing and may occur with opioid or sedative effects, central nervous system depression, or fatigue. When slow breathing is accompanied by shallow excursions, rising PaCO2, drowsiness, or...