CNA Skill Series: How to Count Respirations

Counting respiration cna skillIn today’s article, we will be delving into a topic that is highly relevant and crucial for Certified Nursing Assistants (CNAs) – how to count respirations. As a CNA, it is essential to have a comprehensive understanding of monitoring a patient’s respiratory rate accurately and efficiently. Whether you are a seasoned professional looking for a refresher or a newly certified CNA seeking guidance, this article will provide you with step-by-step instructions and valuable tips to master the art of counting respirations. So, let’s dive in and equip ourselves with the necessary skills to ensure the well-being and care of our patients.

Understanding the importance of counting respirations

As a Certified Nursing Assistant (CNA), there are numerous vital tasks that fall under your responsibility. One of these crucial tasks is counting respirations. While it may seem like a simple task, Accurate respiratory rate measurement is crucial in patient care for several reasons. Firstly, it provides valuable information about a patient’s overall health status. Changes in respiratory rate can indicate underlying issues such as respiratory distress or infection. By monitoring respirations regularly, CNAs can alert the healthcare team to potential problems and allow for early intervention.

Secondly, respiratory rate measurement is an integral part of assessing a patient’s response to treatment. For example, if a patient is receiving oxygen therapy, monitoring their respiratory rate can help determine if the treatment is effective or if adjustments need to be made.

By monitoring respiratory rates, CNAs can identify any abnormalities or changes in breathing patterns, which could indicate potential health issues. For example, an increased respiratory rate could be a sign of respiratory distress or infection, while a decreased rate could indicate respiratory depression or other underlying conditions. By accurately counting respirations, CNAs can alert the nursing staff or healthcare provider promptly, ensuring timely intervention and preventing any further complications.


Step by Step Process of Counting Respirations

To count respirations accurately, follow these step-by-step guidelines:

1. Ensure a calm environment: Find a quiet space where the patient can relax comfortably. A calm environment helps patients breathe naturally and prevents distractions that may affect the accuracy of the count.

2. Observe the patient’s chest: Watch the rise and fall of the patient’s chest as they breathe. It is essential to observe for a full minute to get an accurate respiratory rate. Counting for only 15 or 30 seconds can lead to incorrect results.

3. Count each breath: As the patient inhales and exhales, count each breath silently. Avoid announcing the count aloud, as this may disrupt the patient’s breathing pattern. Count one complete breath (inhale and exhale) as one respiration. Use a timer or watch to count the number of respirations for a full minute. It is crucial to count respirations without interrupting or influencing the patient’s natural breathing pattern.

4. Note any abnormalities: While counting, pay attention to any irregularities in breathing, such as shallow or labored breaths. These observations will assist in providing a more comprehensive assessment of the patient’s respiratory status.

5. Documenting and reporting: Documenting and reporting respirations accurately is a crucial responsibility for CNAs. Your observations and documentation serve as essential information for the healthcare team, assisting in the overall care and treatment plan for the patient. When documenting respirations, ensure you record the time, date, and the number of respirations per minute.

Although counting respirations may seem straightforward, there are some common challenges you may encounter. Patients may be self-conscious or anxious, especially if they are aware that you are observing their breathing. This can cause them to alter their breathing pattern, leading to inaccurate results. To overcome this challenge, try to distract the patient by engaging them in conversation or focusing on a different task while counting their respirations discreetly. Additionally, you may encounter patients with irregular breathing patterns or those who breathe very slowly or rapidly. In such cases, it is essential to count carefully and ensure accuracy by repeating the count if necessary.

Accurate respiratory rate monitoring plays a vital role in patient care and assessment. It assists healthcare providers in determining the effectiveness of treatments, evaluating respiratory function, and detecting any changes that may require immediate attention. By diligently counting respirations, CNAs contribute to the overall well-being and safety of their patients.

Common Mistakes to Avoid When Counting Respirations

When it comes to counting respirations as a Certified Nursing Assistant (CNA), accuracy is key. Properly counting a patient’s respirations can provide valuable information about their overall health and help identify any potential respiratory issues. However, there are several common mistakes that CNAs should avoid to ensure accurate results. In this section, we will discuss these mistakes and provide tips on how to avoid them.

The importance of proper positioning
One of the most common mistakes when counting respirations is not ensuring that the patient is in a comfortable and relaxed position. This can lead to inaccurate results as the patient may not be able to breathe naturally. It is crucial to position the patient in a way that allows their chest to rise and fall freely. This can be achieved by propping them up with pillows or adjusting their bed or chair to a suitable angle. By ensuring proper positioning, CNAs can obtain more accurate respiratory counts.

Avoid distractions
Counting respirations requires focus and attention to detail. However, it is all too easy to get distracted by external factors such as noise, conversations, or other tasks. To avoid this mistake, CNAs should create a calm and quiet environment for the patient during the counting process. It is important to eliminate any unnecessary distractions and concentrate solely on observing the patient’s chest movements and counting the number of breaths. By reducing distractions, CNAs can obtain more accurate respiratory counts.

Counting for an adequate duration
Another mistake to avoid when counting respirations is not counting for a sufficient amount of time. It is recommended to count respirations for a full minute to get an accurate average. Rushing through the process can result in an underestimation or overestimation of the patient’s respiratory rate. Taking the time to count for a full minute allows for a more comprehensive assessment of the patient’s respiratory health. CNAs should remember to be patient and thorough when counting respirations.

Avoiding observer bias
Observer bias can occur when the person counting respirations has preconceived notions or expectations about the patient’s respiratory rate. This can lead to inaccurate results and potentially affect the patient’s care. To avoid this bias, CNAs should approach each counting session with an open mind and remain objective throughout the process. It is important to focus solely on the patient’s chest movements and count each breath without any preconceived notions. By remaining unbiased, CNAs can provide more accurate respiratory counts.

Counting respirations is an essential skill for CNAs, and avoiding common mistakes is crucial for obtaining accurate results. By ensuring proper positioning, avoiding distractions, counting for an adequate duration, and avoiding observer bias, CNAs can improve the accuracy of their respiratory counts. By doing so, CNAs can provide valuable information to the healthcare team and contribute to the overall care and well-being of their patients.



In conclusion, mastering the skill of counting respirations as a CNA is not only essential for providing quality care to patients, but it also serves as a vital indicator of their overall health and well-being. By following the step-by-step guide outlined in this blog post, you can confidently and accurately count respirations, allowing you to identify any abnormalities or changes in a patient’s respiratory status promptly.

Remember, practice makes perfect, so don’t hesitate to continue honing your skills and seeking opportunities to count respirations in real-life scenarios. The more you familiarize yourself with the process, the more confident and efficient you will become.

As a CNA, your dedication to accurate and diligent respirations counting will contribute to better patient outcomes and improved healthcare. So, embrace this skill and let it serve as a cornerstone of your caregiving journey.


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