Selected Areas of Care - Respiratory Management

Respiratory Management

1. Complies with established guidelines
2. Positions the patient to facilitate respiratory hygiene activity(ies)
3. Provides a receptacle to receive secretions as needed
4. Assesses the patient's respiratory status before initiating respiratory hygiene activity(ies) by:
• instructing the patient specifically to breathe in and out as deeply as possible moving the stethoscope from side to side
• observing breathing patterns
5. Directs the patient in or performs one or more respiratory hygiene activity(ies):
• Deep Breathing
• instructs the patient specifically to breathe in and out as deeply as possible
• repeats deepbreathing exercise as ordered or as indicated by the patient's condition
• Coughing:
• instructs the patient specifically to breath in and out deeply
• instructs the patient specifically to cough forcefully on third or fourth expiration
• provides for splinting, whiile the patient is coughing, if necessary
• Mechanical deviceds, such as those used for inspiratory spirometry, etc.
• instructs the patient specifically to use the device
• repeats respiratory exercise as ordered or as indicated by the patient's condition
• Chest Percussion
• claps the designated area(s) of the chest wall vigorously with cupped hands, unless contraindicated
• vibrates the designated area(s) of the chest wall vigorously, unless contraindicated
• Suctioning
• when suctioning by catheter is assigned
• verifies patency of the catheter
• sets the pressure on the suction machine as designated
• inserts the catheter before suctioning
• rotates the catheter continuously during suctioning
• suctions for no more than 15 seconds at a time
• repeats as necessary to remove secretions or
• when suctioning with a bulb syringe is assigned:
• deflates the bulb syringe prior to insertion
• inserts the bulb syringe into the patient's mouth and/or nares before suctioning
• aspirates secretions
• repeats as necessay to remove secretions
6. Reassesses respiratory status immediately after respiratory hygiene activities
7. Records
• bilateral breath sounds heard after treatment in comparison with those heard initially related to each of the above assessment findings
• abnormal breathing patterns
• respiratory hygiene activities implemented