TEACHING DEEP – BREATHING EXERCISES

Definition: __________________________________________________________________________________________________________________

Purpose: __________________________________________________________________________________________________________________

Indication: __________________________________________________________________________________________________________________

PROCEDURE RATIONALE 1 2 3 4 5
1. Assess the client’s condition and identify anything that may
affect the success of the procedure.

Abdominal (diaphragmatic ) and Pursed-Lip Breathing

2. Explain to the client that diaphragmatic breathing can help the
person breath more deeply and with less effort.

3. Have the client assume either a comfortable semi-Fowler’s

position with knees flexed, back supported, and with one head
pillow or a supine position with one head pillow and knees
flexed. After learning, the client can practice.

4. Have the client place one or both hands on the abdomen just
below the ribs.

5. Instruct the client to breath in deeply through the nose with

the mouth closed, to stay relaxed, not to arch the back, and to
concentrate on feeling the abdomen rise as far as possible.

6. If the client has difficulty raising the abdomen, instruct the

person to take a quick, forceful inhalation through the nose.

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7. Instruct the client to purse the lips as if about to whistle; to
breath out slowly and gently, making a slow “ whooshing “
sound; to avoid puffing out the cheeks; to concentrate on
feeling the abdomen fall or sink; and to tighten the abdominal
muscles while breathing out.

8. If the client has COPD, teach the “double cough” technique.

Have the client a. Breath in through the nose and inflate the
lungs to the mid inspiration point, rather than to the full deep
inspiration point.
B. Simultaneously exhale and cough two or more abrupt, sharp
coughs in rapid succession.

9. Instruct the client to use this exercise whenever feeling short

of breath to increase it gradually 5-10 minutes four times a
day.

APICAL EXPANSION EXERCISES

10. Place your fingers below the client’s clavicles and exert
moderate pressure, or have the client place his or her fingers over
the same area.

10. Instruct the client to inhale through the nose and to

concentrate on pushing the upper chest upward and forward
against the fingers.

11. Have the client hold the inhalation for a few seconds.

12. Have the client exhale through the mouth or nose slowly,
quietly and passively while concentrating on moving the upper
chest inward and downward.

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13. Instruct the client to perform the exercise for at least five
respirations four times a day.

BASAL EXPANSION EXERCISES

14. Place the palms of your hands in the area of the lower ribs
along the midaxillary lines, and exert moderate pressure, or
have the client place his or her hands over the same areas.

15. Instruct the client to inhale through the nose and to

concentrate on moving the lower chest outward against the
hands.

16. Have the client hold the inhalation for a few seconds.

17. Have the client exhale through the nose or mouth slowly,
quietly and passively. If the person has COPD, observe the
rate and character of the exhalation. Normal exhalation is
slow, and the upper chest appears relaxed. If the exhalation
appears difficult or there is in drawing of the upper chest,
encourage pursed-lip exhalation.

18. Instruct the client to perform this exercise at least five

respirations four times a day.

19. Correct the patient’s breathing technique as necessary.

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