The information below contains the most common breathing patterns that you’ll see every day on the job, as well as some of the less common ones that we rarely see but yet still need to know because the NBRC likes to ask about them on the TMC Exam.
So no matter where you are on your journey to becoming a Respiratory Therapist, it’s a good idea to go ahead and learn these breathing patterns now so that you’ll be able to implement this information when the time comes. So if you’re ready, let’s go ahead and dive right in!
Types of Breathing Patterns that you must know as a Respiratory Therapist:
Tachypnea – Increased respiratory rate greater than 20 breaths per minute. Caused by hypoxia, fever, pain, or a central nervous system problem.
Bradypnea – Decreased respiratory rate less than 12 breaths per minute. Caused by sleep, drugs, alcohol, and metabolic disorders.
Apnea – No breathing.
Hyperpnea – Increased respiratory rate, rhythm, and depth of breathing. Usually caused by metabolic or CNS disorders.
Cheyne-Stokes – An abnormal breathing pattern with periods of progressively deeper breaths alternating with periods of shallow breathing and apnea.
Biot’s – Breathing characterized by irregular periods of apnea alternating with periods in which four or five breaths of identical depth are taken. Similar to Cheyne-Stokes except that each breath has the SAME depth.
Kussmaul’s – Remember: DEEP and FAST. Increased respiratory rate and depth, with an irregular rhythm. This is a labored form of breathing that is usually associated with diabetic ketoacidosis.
Apneustic – An abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by a brief, insufficient release.
Practice Questions about Breathing Patterns:
1. What is the best technique to assess a patient’s respirations accurately?
Place a hand on the upper abdomen and observe the rise and fall of the chest.
2. What is Apnea?
It is the complete absence of breathing.
3. What is Eupnea?
4. What is Biot’s Breathing?
Short episodes of rapid, uniformly deep inspirations, followed by 10-30 seconds of apnea. It is most often seen in patients with meningitis.
5. What is Hyperpnea?
Increased depth (volume) of breathing with or without an increased frequency.
6. What is Hyperventilation?
An increased rate or depth of breathing that causes an increase in CO2.
7. What is Tachypnea?
A rapid rate of breathing when the respiratory rate is greater than 24.
8. What is Cheyne-Stokes Breathing?
It is a gradual increase and then a decrease in the rate and volume of breathing, followed by 5-10 seconds of apnea. It most often occurs in patients with cerebral disorders and CHF.
9. What is Kussmaul’s Breathing?
Both an increased depth (hyperpnea) and rate of breathing. With this pattern, the CO2 decreases, while the oxygen increases.
10. What is Orthopnea?
A condition in which an individual is able to breathe most comfortably only in an upright position. They have difficulty breathing while lying down.
11. What is Dyspnea?
Difficulty in breathing, of which the individual is aware. It is also called – shortness of breath.
12. What is the purpose of pursed-lip breathing?
To prevent the air trapping caused by bronchiolar airway collapse by increasing the back pressure; it also helps to aid with panic attacks.
13. How do you perform pursed-lip breathing?
Take a deep breath in and hold; then breathe out with your lips puckered like you’re blowing out a candle.
14. The physiological effects of pursed-lip breathing will do what?
It will decrease the patient’s respiratory rate by increasing the expiratory rate.
15. What are the diseases that are helped with pursed lip breathing?
COPD and emphysema.
16. What is the purpose of abdominal diaphragmatic breathing exercises?
This promotes a greater use of the diaphragm, decreases the work of breathing by slowing your breathing rate, decreases oxygen demand, uses less effort and energy to breathe, and helps to prevent atelectasis.
17. What is a disease that will benefit from diaphragmatic breathing?
18. What is lateral costal breathing?
Unilateral or bilateral costal breathing exercises increase ventilation to the lower lobes and aid in diaphragmatic breathing.
19. What patients use lateral costal breathing?
Post-surgery, pregnancy, or ascites patients.
20. What are the purposes of breathing exercises?
To promote efficient use of the diaphragm, to decrease the use of the rib cage, and to improve cough and the efficiency of ventilation.
21. What are the 4 phases of a cough?
Irritation, inspiration, compression, and expulsion.
22. What is a direct cough?
A deliberate maneuver that is taught,
23. What is the incentive spirometer technique?
A technique using visual feedback to encourage patients to take a slow, deep sustained inspiration.
24. What is a sustained maximal inspiration?
A method to get the patient to hole the inspiratory effort as long as possible.
25. What is Apneustic Breathing?
A prolonged inspiration and a regular expiration. It is caused by a brain injury.
26. What is Paradoxical Breathing?
The chest depresses on inspiration, and on expiration, the chest puffs. It is caused by a chest injury.
27. How would you describe asthmatic breathing?
A prolonged expiration and a regular inspiration.
28. What is Platypnea?
When the patient can breathe better when laying down.
29. What is Orthopnea?
When the patient can breathe better when sitting up.
30. What can result from hypoventilation?
31. What does hypercapnia mean?
Increases arterial PCO2.
32. How is hypercapnia counteracted?
By an increased ventilation rate and depth.
33. What is hyperventilation?
An increased ventilation rate and depth.
34. What can hyperventilation cause?
35. What can hypocapnia cause?
A decrease in the arterial PCO2.
You’re an action-taker! And I like that!
This gives me a good feeling that you are going to do very well when you take the TMC Exam. Keep working and studying hard — it’s going to pay off for you in a big way. Breathe easy, my friend!