patient prep vitals

Respiration Measurement

Counting respirations gives the breathing rate and, if you watch for it, early signs of respiratory distress.

10 steps3 criticalLimit 2 minAlways tested

Steps

1Perform hand hygiene, introduce yourself, and identify the patient (for example by name and date of birth)
2Critical stepProvide privacy and explain the visit in general terms; do not tell the patient you are counting breaths
3Take the pulse first, then keep your fingers on the wrist as if still counting the pulse
4Ask the patient to stay quiet and make sure bulky clothing does not hide the chest
5Critical stepWatch the chest, abdomen or shoulders rise and fall; one breath is one full cycle of breathing in and out
6Count the breaths for a full 60 seconds with a watch or clock that has a second hand
7Critical stepWhile counting, note whether breathing is quiet and even, and look for loud breathing, nasal flaring, neck, chest or rib muscle use, or leaning forward
8Notify the nurse or provider right away if you see new signs of respiratory distress
9Check that the patient is comfortable and perform hand hygiene
10Document the rate in breaths per minute (and the situation if the patient was not at rest), and report an adult rate outside 12 to 20 per facility policy

Tips

The most accurate count is made when the patient is not aware you are watching their breathing, because knowing can change the pattern
The normal resting adult respiratory rate is 12 to 20 breaths per minute; report an adult rate outside that range
One breath is one full cycle: the chest rising and falling once counts as one, not two

Announcing that you are counting breaths, so the patient breathes self-consciously.
Counting the rise and the fall as two breaths.
Letting the patient talk or move during the count.
Recording only a number and missing new signs of respiratory distress.

Practice this skill

Practise the sequence in the app with critical-step highlighting and a rationale for each step.

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Sources and how we check them: How we verify.