MICROTEACHING

ON
ABNORMAL RESPIRATION

SUBMITTED TO: SUBMITTED BY:

MRS. SHIPRA MODAK GOURI HALDER
SENIOR LECTURER MSC NURSING (1ST YEAR)
W.B.G.C.O.N W.B.G.C.O.N
SSKM CAMPUS SSKM CAMPUS
KOLKATA 20 KOLKATA 20
Introduction :
There are multiple types of normal and abnormal respiration. They include apnea, eupnea,
orthopnea, dyspnea, hyperpnea, hyperventilation, hypoventilation, tachypnea, Kussmaul
respiration, Cheyne-Stokes respiration, Biot respiration, apneustic breathing, etc. Each pattern
is clinically important and useful in evaluating patients

Definition :
Respiration is the act of breathing . It involves two involuntary process i,e inspiration
(inhalation) and expiration (exhalation) . Respiration may be internal or external. External
respiration or pulmonary respiration is the exchange of gases between environment and lungs
where as internal respiration is the movement of oxygen between blood and cell.

Respiratory Pattern :
A patient’s respiratory pattern refers to the rate, depth, and rhythm at which they are breathing.
In a healthy patient at rest, the respiratory rate should be 12-20 breaths per minute, with passive
exhalation and a normal rhythm. Again, this is known as eupnea (i.e., normal breathing).

Function :
Evaluating respiratory patterns assists the clinician in understanding the patient's current
physiologic status. Abnormal breathing patterns suggest the possibility of an underlying injury or
metabolic derangements. Early recognition of abnormal respiratory patterns can aid the clinician in
early intervention to prevent further deterioration of the patient's condition.
Types of Abnormal Respiratory Patterns :
When a patient’s breathing deviates from normal, it is considered to be an abnormal respiratory
pattern. There are several different types, including the following:
1.Tachypnea
2.Bradypnea
3.Apnea
4.Cheyne-Stokes breathing
5.Kussmaul breathing
6.Biot’s breathing
7.Hyperpnea
8.Hypopnea
9.Orthopnea
10.Apneustic breathing
11.Agonal breathing
12.Ataxic breathing
13.Paradoxical breathing
14.Hyperventilation
15.Hypoventilation
etc
 Tachypnea
Tachypnea is an abnormal breathing pattern characterized by rapid breathing. It is defined as a
respiratory rate that is greater than 20 breaths per minute. Tachypnea does not have a single
specific cause, but it is often seen in patients who are struggling to breathe, such as those with
heart failure, COPD, or pneumonia.
Some other common causes of tachypnea include:
o Sepsis
o Hypoxemia
o Diabetic ketoacidosis
o Carbon monoxide poisoning
o Pulmonary embolism
o Asthma

 Bradypnea
Bradypnea is the opposite of tachypnea and is defined as a respiratory rate of fewer than 12 breaths
per minute. As with tachypnea, bradypnea does not have a single specific cause, but it is often seen
in patients who are sedated or have a central nervous system disorder.Some other common causes
of bradypnea include:Drug overdose, Hypothyroidism, Brain injury

 Apnea
Apnea is a term that refers to the absence of spontaneous breathing.This means that there is no
effort or movement of the inspiratory muscles, and the volume of the lungs does not change. Apnea
can cause severe complications throughout the body because, without breathing, the tissues and
organs are unable to obtain the oxygen that is required for survival.Some of the common causes of
apnea include:
o Cardiac arrest
o Severe brain trauma
o Neuromuscular disorders
o Central nervous system disorders
o Narcotic overdose

 Cheyne-Stokes Breathing
Cheyne-Stokes breathing is an abnormal respiratory pattern that is characterized by periods of
shallow and deep breathing, separated by brief periods of apnea.This breathing pattern is often
seen in patients who are in a comatose state and is caused by a lack of oxygen to the brain. Some
other causes include:
o Increased intracranial pressure
o Traumatic brain injury
o Stroke
o Heart failure
o Hyponatremia
o Brain tumor

 Kussmaul Breathing
Kussmaul breathing is an abnormal respiratory pattern that is characterized by deep and rapid
breathing. This is often seen in patients with metabolic acidosis.

 Biot’s Breathing
Biot’s breathing is a chaotic respiratory pattern that is characterized by irregular periods of deep,
shallow, fast and slow breathing. This pattern eventually turns into agonal breathing, which then leads
to apnea.Biot’s breathing is often seen in patients with an acute neurological disease that results in
damage to the medulla or pons in the brain.This can occur due to a stroke, trauma, or severe
intracranial hypertension.
 Hyperpnea
Hyperpnea is an abnormal breathing pattern characterized by an increased depth of breathing with
or without an increase in rate. Therefore, the blood gas values of a patient with hyperpnea are
normal.The most common causes of hyperpnea include:
o Exercise
o High altitude
o Anemia
o Asthma
o Acute lung injury
o COPD
 Hypopnea
Hypopnea is an abnormal respiratory pattern characterized by a decrease in depth of breathing with
or without a decrease in rate. This can result in hypoxemia and an increase in PaCO2. This breathing
pattern is often associated with obstructive sleep apnea and is caused by a partial obstruction of the
upper airway.
 Orthopnea
Orthopnea is an abnormal respiratory pattern characterized by shortness of breath while lying flat.
This is often seen in patients with congestive heart failure (CHF) and is caused by the accumulation
of fluid in the lungs.
 Apneustic Breathing
Apneustic breathing is an abnormal respiratory pattern characterized by a deep and gasping inspiration
with a pause at full inspiration, followed by a brief, partial expiration. This pattern is often seen in
patients who’ve experienced severe brain damage to the upper medulla or pons caused by a stroke or
trauma. It is also seen in patients with a hypoglycemic coma or those with profound hypoxemia.
Apneustic breathing is caused by basilar artery occlusion and usually has a poor prognosis.
 Agonal Breathing
Agonal breathing is an abnormal respiratory pattern characterized by intermittent gasping and labored
breathing.It is caused by a preterminal brainstem reflex and eventually progresses to complete apnea.
This breathing pattern often occurs during the final breaths before death.
Some of the most common causes of agonal breathing include:
o Cerebral ischemia
o Extreme hypoxemia
o Anoxia
 Ataxic Breathing
Ataxic breathing is an abnormal respiratory pattern characterized by irregular respirations with
abnormal pauses and periods of apnea.This means that the patient will have a variable respiratory
rate, breathing cycle, and inconsistent tidal volumes with both small and large breaths. The periods of
apnea occur abruptly and sporadically throughout the breathing cycle.This breathing pattern often
occurs when there is damage to the medullary respiratory center in the brain, which is caused by:
Head trauma, Traumatic brain injury, Brain tumor, Increased intracranial pressure.
 Paradoxical Breathing
Paradoxical breathing is an abnormal respiratory pattern characterized by an inward movement of the
chest wall during inhalation followed by an outward movement during exhalation.It can result from
diaphragmatic fatigue or paralysis; however, it’s most commonly associated with trauma or an injury to
the chest wall.For example, a flail chest is a traumatic injury where a portion of the rib cage is fractured
and becomes detached. When this occurs, the flail section moves in the opposite direction, which is
known as a paradoxical movement.This abnormal pattern may also occur in infants and children as a
sign of respiratory distress.
 Hyperventilation
Hyperventilation is a type of abnormal respiration characterized by an increase in the rate and
depth of breathing. This results in a decrease in the levels of carbon dioxide in the blood, which
results in respiratory alkalosis. Some of the most common causes of hyperventilation include:
o Anxiety disorders
o Panic attacks
o Severe pain
o Lung infections
o COPD
o Asthma
o Myocardial infarction
o Diabetic ketoacidosis
o Head injuries
o Hyperventilation syndrome
 Hypoventilation
Hypoventilation is a type of respiratory depression characterized by a decrease in the rate and
depth of breathing. This results in an increase in the levels of carbon dioxide in the blood, which
results in respiratory acidosis. Some of the most common causes of hypoventilation include:
o Stroke
o Brainstem injury
o Drug overdose
o Hypocapnia
o Obesity hypoventilation syndrome
o Neuromuscular diseases
o Chest wall deformities
o Obstructive sleep apnea

 Bibliography
1) Concise course in nursing Foundation – 1, Javed Ansari 1 st edition, S.vikas and company medical
publishers, page 221
2) BSC Nursing semester – 1 nursing foundation, Dr Mahesvari Ganesan, Rames S, Priya P.M, Linda
Daphane.T, 1st edition, Nirali Prakashan, page – 6:50 – 6:51
3) Nursing Foundation for BSC Nursing Students, Celestina Francis, Kritika Misra, 1 st edition, Lotus
publishers, page - 128