Well-Child Respiratory Assessment Tips

Assessing respiratory function in young children can be challenging. The nurse must adapt techniques to match the child's age and developmental level while systematically assessing the child's compete physical condition. Providing a quite, warm and comfortable environment will likely improve the quality of the assessment. The very young are at risk for hypothermia, they may require additional warmth.

Greeting observations:

History

Inspection

Auscultation

Use a pediatric stethoscope (diaphram) when listening to the chest of infants and young children. Listen to the full inspiration & expiration of a cycle before moving the stethoscope; abnormal sounds can be generated in one portion of the cycle. Breath sounds of toddlers are generally more intense and bronchial sounding than adults, with expiration more pronounced than inspiration.

Palpation

Wash and warm the hands to gently examine the tracheal mobility & alignment, head & neck lymph nodes, anterior & posterior chest. Observe for:

When doing the assessment, keep in mind that respiratory rate of a child is more rapid than an adult.

Normal Respiratory Rate in Children
Age Group

Respiratory Rate
(Breath rate)

Infant

<1 year

bradypnea <30 - 60> tachypnea

Toddler

1 - 3 years

24 – 40

Preschooler

3 - 6 years

22 - 34

School-age

6 - 12 years

18 - 30

Adolescent

13 - 18 years

12 - 20

View this UBC Learn Pediatrics "Learn Peds Respiratory - Palpation".

 


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