Chapter 3: Pulse and Respiration
Respiration refers to a person’s breathing and the movement of air into and out of the lungs (OER #2). The respiratory system provides oxygen to body tissues for cellular respiration, removes the waste product carbon dioxide, and helps maintain acid–base balance (OER #2). Inspiration is the process that causes air to enter the lungs, and expiration is the process that causes air to leave the lungs (OER #2). A respiratory cycle (or one breath while you are measuring respiratory rate) is one sequence of inspiration and expiration (OER #2).
Respiration is assessed for quality, rhythm, and rate.
The quality of a person’s breathing is normally relaxed and silent. Healthcare providers assess use of accessory muscles in the neck and chest and indrawing of intercostal spaces (also referred to as intercostal tugging), which can indicate respiratory distress. Respiratory distress can also cause nasal flaring, and the person often moves into a tripod position. The tripod position involves leaning forward and placing arms/hands and/or upper body on one’s knees or on the bedside table.
Respiration normally has a regular rhythm. A regular rhythm means that the frequency of the respiration follows an even tempo with equal intervals between each respiration. If you compare this to music, it involves a constant beat that does not speed up or slow down, but stays at the same tempo.
Respiratory rates vary based on age. The normal resting respiratory rate for adults is 10–20 breaths per minute (OER #1). Children younger than one year normally have a respiratory rate of 30–60 breaths per minute, but by the age of ten, the normal rate is usually 18–30 (OER #2). By adolescence, the respiratory rate is usually similar to that of adults, 12–18 breaths per minute (OER #2). The normal respiratory rate for children decreases from birth to adolescence (OER #2). Respiratory rates often increase slightly over the age of sixty-five.
Estimated respiratory rates vary based on the source. Table 3.2 lists a generous range of normal respiratory rates based on age. It is important to consider the client and the situation to determine whether the respiratory rate is normal. Healthcare providers take into consideration the client’s health and illness state and determinants such as rest/sleep, awake/active, presence of pain, and crying when assessing the respiratory rate.
Table 3.2: Respiratory Rate Ranges
| Age | Rate (breaths per minute) |
|---|---|
| Newborn to one month | 30–65 |
| One month to one year | 26–60 |
| 1–10 years | 14–50 |
| 11–18 years | 12–22 |
| Adult and older adult | 10–20 |
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Part of this content was adapted from OER #1 (as noted in brackets above):
© 2015 British Columbia Institute of Technology (BCIT). Clinical Procedures for Safer Patient Care by Glynda Rees Doyle and Jodie Anita McCutcheon, British Columbia Institute of Technology. Licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. Download this book for free at http://open.bccampus.ca
Part of this content was adapted from OER #2 (as noted in brackets above):
© Apr 10, 2017 OpenStax Anatomy and Physiology. Textbook content produced by OpenStax Anatomy and Physiology is licensed under a Creative Commons Attribution License 4.0 license. Download for free at http://cnx.org/contents/7c42370b-c3ad-48ac-9620-d15367b882c6@12