Breathing: Oxygen and Holland Et Al

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Breathing is a critical component of respiration, a process in which life sustaining oxygen is delivered to all the cells in the body and carbon dioxide is removed and released into the air. Breathing difficulties are symptoms of a variety of mild to serious underlying disorders, diseases and conditions that interfere with normal respiration and breathing. Hence, the ability to carry out and document a full respiratory assessment is an essential skill for all nurses. While conducting the assessment, nurses must be able to recognise and assess symptoms of respiratory dysfunction to provide early, effective and appropriate interventions, thus improving client outcomes. In this essay will discuss the skills nurses must possess during a respiratory assessment and the nursing actions that assist clients in breathing.

It is vital that nurses have knowledge of the anatomy and physiological process of a healthy functioning pulmonary system, in order to carry out a respiratory assessment (Cox & McGrath 1999, p. 226). Breathing is the effort required to expand and contract the lungs. ‘Most individuals breathe unaided and independently from birth throughout their life span until the moment of death... It is the cessation of breathing that signifies death (Holland et al. 2008, p. 138). Breathing is usually the first vital sign to alter in a deteriorating client. This is why a respiratory assessment should be carried out by a nurse with a complete understanding of the system so they can diagnose and manage respiratory conditions in clients. Holland et al. (2008, p. 157) states that there are three phases involved in a respiratory assessment which include the collection of data, interpretation of the data, and identifying the clients actual and potential problems.

According to Hunter (2008, p. 41) before proceeding with a physical respiratory assessment, it is important that nurses obtain information that may be relevant to the client’s respiratory status such as medications, their medical history, occupation, and smoking history. A client should be able to answer questions without any breathing difficulties. However, if the client is unable to communicate, information can be gathered from other sources such as family members or past records. A nurse must demonstrate active listening skills when collecting client history to ensure effective communication. The appropriate use of eye contact is one of the most significant and prevailing techniques for indicating true concern about a client. Eye contact should be established often enough and long enough to be encouraging and not make the client feel uncomfortable (Higgs et al. 2008, p. 106). Nurses must also ask for clarification on certain points, take brief notes, and allow time for silence during the collection of information to demonstrate active listening. When a client’s history is correctly recorded nurses are provided with an organised, unbiased, detailed and chronologic report of the development of symptoms that has caused the client to seek health care (Hunter 2008, p. 42). However, history taking maybe limited depending on the severity of the breathing condition and therefore observation skills may need to be used (Moore 2007, p. 51).

Kennedy (2007, p. 43) claims that ‘the physical examination only serves to reinforce the information derived from the history’. Using observation skills such as reading body language and facial expression is important because ‘if non-verbal messages conflict with verbal messages, we are more likely to believe the nonverbal’ (Higgs et al. 2008, p. 16). When collecting data about a clients breathing condition, nurses should assess the client’s vital signs such as respiratory rate, depth of breathing, rhythm of breathing, changes in breathing habit, coughing, production of abnormal secretions, and pain, as well as general appearance (Holland et al. 2008, p. 159).

Holland et al. (2008, p. 159), affirms that it is ‘relatively easy for a...
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