The nurse notes documentation that a client is exhibiting Cheyne-Stokes respirations. On assessment, what finding would the nurse expect?
A.
Regular deep respirations interspersed with periods of apnea
B.
A pattern of crescendo-decrescendo respirations followed by a period of apnea
C.
Patient breathing less than 10 breaths per minute
D.
Patient breathing shallow and more than 24 breaths per minute
The Correct Answer and Explanation is:
The correct answer is B. A pattern of crescendo-decrescendo respirations followed by a period of apnea.
Explanation:
Cheyne-Stokes respirations are characterized by a distinct pattern of breathing that includes alternating periods of deep and shallow breaths, interspersed with periods of apnea (no breathing). This pattern is often described as crescendo-decrescendo, which means the breathing gradually increases in depth and rate (crescendo), reaches a peak, and then decreases in depth and rate (decrescendo) before a period of apnea.
Here’s a detailed breakdown of what this means in clinical practice:
- Crescendo-Descrescendo Pattern: In Cheyne-Stokes respirations, the breathing pattern typically starts with shallow breaths that gradually become deeper and more rapid. This is the crescendo phase. After reaching a peak, the breathing becomes progressively shallower and slower, which is the decrescendo phase. This cycle is then followed by a brief period of apnea, where no breathing occurs. This cycle repeats itself, often observed over several minutes.
- Clinical Significance: Cheyne-Stokes respirations are often associated with serious conditions affecting the brainstem or severe heart failure. The pattern can be seen in conditions such as congestive heart failure, stroke, traumatic brain injury, or as part of the dying process in terminally ill patients. It is indicative of an issue with the brain’s ability to regulate breathing patterns effectively.
- Differentiation from Other Patterns:
- Regular Deep Respirations Interspersed with Periods of Apnea (Option A): This describes another type of breathing pattern but not the crescendo-decrescendo characteristic of Cheyne-Stokes respirations.
- Breathing Less Than 10 Breaths Per Minute (Option C): This could indicate bradypnea, but it does not describe the alternating pattern seen in Cheyne-Stokes respirations.
- Shallow Breathing More Than 24 Breaths Per Minute (Option D): This would suggest tachypnea with shallow breathing, but not the cyclical pattern of Cheyne-Stokes respirations.
Understanding and recognizing Cheyne-Stokes respirations are crucial for healthcare providers to assess and manage patients with serious health conditions, as this pattern can provide important clues about the underlying physiological state and may influence care decisions.