Results of arterial blood gas analyses should be monitored and the patient observed for fatigability when engaged in various levels of activity. Special observations and methods of assessment of a patient who has dyspnea include: auscultation of the chest for abnormal breath and voice sounds, lung aeration, rales, and rhonchi inspection of the chest for respiratory rate and rhythm and for symmetrical expansion inspection of the skin, lips, and nail beds for cyanosis and percussion of the chest for abnormal resonance. If they already know how to do pursed-lip breathing (inhaling slowly through the nose and exhaling slowly through pursed lips), they may need to be reminded of it and encouraged to use it to improve breathing. We considered reports of paroxysmal nocturnal dyspnea that is a sensation of shortness of breath that awakens (Ekundayo et al., 2009), and of orthopnea, the. Once dyspneic patients are comfortable and less apprehensive, they may need instruction in prolonged, controlled exhalation. 17 However, the occurrence of paroxysmal nocturnal dyspnea is a more specific indicator of heart failure. ![]() If abdominal distention, ascites, or a massive tumor interferes with chest expansion and produces dyspnea, having the patient lie on one side and supporting the abdomen with pillows may provide some relief. Dyspnea on exertion is usually the earliest symptom of heart failure. Helping the patient relax muscles not needed for breathing conserves oxygen and promotes rest. High Fowler's position or orthopneic position with the arms resting on pillows on an overbed table will help improve chest expansion. The patient should respond favorably to a calm, reassuring manner and an explanation of what is being done to relieve the shortness of breath. If the patient is suffering from an acute attack of dyspnea and has a history of chronic airflow limitation, certain nursing measures can help relieve anxiety and improve ventilation. Shortness of breath known medically as dyspnea is often described as an intense tightening in the chest, air hunger or a feeling of suffocation. If there is airway obstruction, clearing the airway is necessary, or a tracheotomy may be performed. Shortness of breath: Few sensations are as frightening as not being able to get enough air. In cases of acute respiratory distress, it may be necessary to intubate the patient, begin oxygen therapy, and obtain laboratory arterial blood gas data. If the patient is acutely short of breath, corrective measures should be instituted promptly. A current and past history are obtained and a physical examination completed as soon as possible. Whatever the cause of dyspnea, the plan of care begins with treating the patient and providing adequate oxygenation.Ī thorough assessment of the patient's condition is necessary in order to ascertain the extent of the problem and the urgency of the need. ![]() The dyspneic patient has some degree of difficulty in meeting the basic physiologic need for adequate levels of oxygen in the blood and the transportation of that oxygen to all cells of the body.
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