1 Respiratory Assessment
Learn how to inspect breathing, measure respiratory rate, assess breath sounds, and interpret findings alongside vital signs, baseline, and clinical context.
A whole-patient assessment
Respiratory assessment combines what you see, what you hear, and the patient’s vital signs. Compare findings with the person’s baseline and interpret them together: a single measurement or breath sound does not establish a diagnosis.
For an adult at rest, a of breaths per minute is a common reference range. Interpret the value in context, including the patient’s age and clinical condition.
Inspect breathing and chest movement
Observe alertness, breathing rate and pattern, effort, and whether the chest rises evenly. Symmetrical chest movement with regular, effortless breathing is reassuring. Unequal rise of the two sides indicates asymmetrical and should be documented.
Signs that may indicate increased respiratory effort include , nasal flaring, pursed-lip breathing, and use of . Rapid breathing, use of neck muscles with each breath, and frequent pauses while speaking are concerning findings that call for prompt assessment; do not assume a single cause.
Measure
Count respirations for a full minute while observing the breathing pattern and effort. Watching without drawing attention to the count can help you observe the patient’s usual pattern. Note rate, rhythm, depth, and effort.
A resting adult breathing times per minute has an increased relative to the common adult reference range. Interpret the measurement with the patient’s age, clinical condition, baseline, and other findings rather than in isolation.
Assess breath sounds
Auscultate systematically and document the location and character of breath sounds. Note where an is heard, whether it occurs during inspiration or expiration, and whether breath sounds are diminished or absent in any area.
is an . Vesicular sounds over peripheral lung fields and breath sounds heard over the trachea are also relevant observations. A sound alone does not identify its cause.
Interpret findings and respond to change
A focused respiratory assessment brings together inspection, auscultation, and relevant vital signs. Include and pattern, and accessory-muscle use, chest symmetry and expansion, breath sounds and their location, and relevant vital signs such as pulse and .
Compare current findings with the patient’s baseline and consider trends. For example, a rising from to breaths per minute over an hour, alongside a faster pulse, may signal deterioration. Reassess respiratory status and other vital signs, then promptly report or escalate the change rather than waiting for a routine observation or assuming a cause.
New altered alertness, labored breathing, and markedly reduced breath sounds on one side are concerning findings that require prompt reassessment and urgent help according to the patient’s condition and local protocol. For concerning or worsening findings, act according to clinical urgency and follow local escalation procedures.