When counting respirations, the CNA should:

Explanation

Awareness of being observed alters the natural respiratory pattern, causing the resident to breathe faster, slower, or deeper. Best practice: keep fingers on the radial pulse after counting pulse and continue to count respirations covertly, observing chest rise and noting depth, rhythm, and effort. Announcements (c), instructions to alter pattern (d), and breath-holding (b) all produce inaccurate readings. Accurate respiratory rate is a sensitive early indicator of deterioration in sepsis, pneumonia, and cardiac compromise.