RESPIRATORY RATE

Respiratory rate is an indicator of how well oxygen is being provided by the tissues of the body by watching, listening or feeling the movement of inspiration (inhalation) and expiration (exhalation) on the patient's back, stomach and chest. While Respiration is an act of breathing. 

Characteristic of Respiration 

When the Respiratory Rate (RR) is taken, the following should be noted:

1. Respiratory Rate 

• Number of respirations per minute

2. Respiratory Rhythm

• Regular and equal spacing of breathing. The cycle of inspiration and

      expiration have the same depth and rate in regular rhythm. 

3. Respiratory Depth 

• The volume of air that is inhaled or exhaled. It is described as either shallow or deep. Hyperventilation refers to deep and rapid respiration and Hypoventilation refers to shallow and slow breathing. 

4. Respiratory Quality 

• Refer to breathing patterns both normal and abnormal.

5. Respiratory Sound 

• Normal Respiration should not have any noticeable sound. However, certain diseases can cause irregular respiration sounds. 

BREATH SOUNDS

1. Rhonchi - low pitched breath sounds that are similar to snoring

2. Crackles - high pitched breath sounds that are similar to popping or snapping

3. Wheezing - a high pitched whistling sound that occurs due to the narrowing of the bronchial tubes

4. Stridor - a harsh, vibratory sound that occurs due to the narrowing of the upper airway, heard most prominently when inhaling. 

5. Pleural Friction Rub - The membranes that cover the walls of your chest cavity and the outer surface of your lungs are called pleura. If they get inflamed and rub together, they can make this rough, scratchy sound. 

6. Whooping - This high-pitched gasp typically follows a long bout of coughing. If you hear a whoop when you breathe in, it may be a symptom of whooping cough (pertussis), a contagious infection in your respiratory system. 

Factors Affecting Respiration

1. Elevated Temperature

2. Age

3. Pain

4. Medication

5. Some Medical Conditions

6. Physical Activity

7. Altitudes

8. Excitement/Anger/Nervousness

Abnormal Breathing Patterns

• Apnea - Absence of breathing. 

• Eupnea - Normal breathing. 

• Orthopnea - Difficulty or unable to breath while lying down. 

• Dyspnea - subjective sensation related by patient as breathing difficulty.

• Paroxysmal Noctural Dyspnea - attacks of sever shortness of breath that wakes a person from sleep.

•  Hyperpnea - Increased depth of breathing. Hyperventilation - Increased rate or depth or combination of both.

•  Hypoventilation - Decreased rate or depth or combination of both. Tachypnea - Respiratory rate higher than the normal range

• Bradypnea - Respiratory rate lower than the normal range. 

• Kussmaul's Respiration - Deep and labored breathing pattern often associated with severe metabolic acidosis, particularly Diabetic Ketoacidosis (DKA) but also Kidney Failure.

BLOOD PRESSURE

It is defined as the amount of force exerted on arterial walls while the heart is pumping blood. Specifically, when the ventricle contracts. It measured by gauging the force by two specific reading, the systolic and diastolic. 

Systolic Blood Pressure 

• The highest pressure that occurs on the left ventricles of the heart when contracting. Diastolic Blood Pressure - Is the lowest pressure level that occurs when the heart is relaxed and the ventricle is at rest and refilling with blood. Blood pressure is read as milimiter of mercury (mmHg). It is recorded as Systolic over Diastolic or 120/80 for example.

 Pulse Pressure 

• Is the difference between Systolic reading and Diastolic reading when you subtracted it. For example, if the blood pressure is 120/80 mmHg then the pulse pressure is 40. A pulse pressure greater than 40 mmHg is considered widened, and less than 30 mmHg is considered as narrowed. A widened pulse pressure can be an indication of cardiovascular diseases and anemia. A narrowed pulse pressure can be an indication of congestive heart failure (CHF), stroke or shock. 

Types of Pain

• Acute pain - Acute pain is short-term pain that comes on suddenly and has a specific cause, usually tissue injury. Generally, it lasts for fewer than six months and goes away once the underlying cause is treated. 

• Chronic Pain - Pain that lasts for more than six months, even after the original injury has healed, is considered chronic. Nociceptive pain - Is the most common type of pain. Its caused by stimulation of nociceptors, which are pain receptors for tissue injury. 

• Visceral pain - Results from injuries or damage to your internal organs. You can feel it in the trunk area of your body, which includes your chest, abdomen, and pelvis. Its often hard to pinpoint the exact location of visceral pain. 

• Somatic pain - Results from stimulation of the pain receptors in your tissues, rather than your internal organs. This includes your skin, muscles, joints, connective tissues, and bones. Its often easier to pinpoint the location of somatic pain rather than visceral pain.  

• Neuropathic pain - Results from damage to or dysfunction of your nervous system. This results in damaged or dysfunctional nerves misfiring pain signals. This pain seems to come out of nowhere, rather than in response to any specific injury. 

• Idiopathic pain - Pain that is no known cause or origin. 

• Phantom pain - Refers to ongoing sensation of pain from a body part that is no longer there.