2.  The  Act of breathing  Exchange of oxygen and carbon dioxide from the air into our lungs  1 inhalation + 1 exhalation = 1 respiration, (complete breath)

3.  Observe the clients chest movement for 1 min.  In adults and older children observe chest movements  Children under 7 use abdominal movement  Auscultation with a stethoscope is also a method to asses respiratory rate

4.  Rate, Rhythm and Quality  Rate:  # of breaths per minute  Adult rate = 12 – 20 breath per minute  Respiratory rates (RR) decrease as a person increases in size  Who will have a higher RR? A 7 year old or 100 year old?  Who will have a higher RR a 100lb women or 200lb man?  Hypoventilation: decrease in rate  Caused by medication, decreased body temp, lack of oxygen

5.  Rate, Rhythm and Quality  Rhythm:  Pattern should be regular.  EX: of irregular: Cheyne-Stokes  Shallow breaths that go deeper and deeper  Decrease to more shallow breaths  Period of apnea  Last from 5-40 seconds

6.  Rate, Rhythm and Quality  Quality:  Seen in volume and effort.  Volume: amount of air taken into and exhaled from lungs  Documented as shallow or deep breathing  Effort: amount of work the client uses in order the breathe  Client uses other muscles in neck, chest, and abdomen

7. www.med.ucla.edu/wilkes/lungintro.htm

8. Crackles (or rales) are caused by fluid in the small airways The popping sounds produced are created when air is forced through respiratory passages that are narrowed by fluid, mucus, or pus. Crackles are often associated with inflammation or infection of the small bronchi, bronchioles, and alveoli. Water logged alveoli www.rale.ca/Crackles_a.htm www.meddean.luc.edu/lumen/MedEd/medicine/ pulmonar/pd/step29e.htmwww.meddean.luc.edu/lumen/MedEd/medicine/ pulmonar/pd/step29e.htm (case 3)

9. Wheezes are sounds that are heard continuously during inspiration or expiration They are caused by air moving through airways narrowed by constriction or swelling of airway or partial airway obstruction. www.rale.ca/Wheezing_b.htm

10. Stridor refers to a high-pitched harsh sound heard during inspiration. Stridor is caused by obstruction of the upper airway, is a sign of respiratory distress and thus requires immediate attention. www.rale.ca/Stridor.htm

11. Pleural friction rubs are low-pitched, grating, or creaking sounds that occur when inflamed pleural surfaces rub together during respiration. www.meddean.luc.edu/lumen/MedEd/medicine/pul monar/pd/step29e.htmwww.meddean.luc.edu/lumen/MedEd/medicine/pul monar/pd/step29e.htm (case 2) www.meddean.luc.edu/lumen/MedEd/medicine/pul monar/pd/step29e.htmwww.meddean.luc.edu/lumen/MedEd/medicine/pul monar/pd/step29e.htm (case 9)

12. www.meddean.luc.edu/lumen/MedEd/medicine/ pulmonar/pd/step29e.htm