Wheezing is a universal clinical manifestation experienced as high pitched whistling sounds in respiration. Moreover, it is an all clear indication that there is an intricacy of the respiratory system. Wheezing can be found in most patient populations and especially in patients diagnosed with asthma, chronic obstructive pulmonary disease (COPD), and other respiratory problems.
The nursing diagnosis for wheezing is important because it forms the basis for nursing intervention, patient education, and cooperative care strategies aimed at achieving more positive patient outcomes. This article will elaborate nursing diagnosis with regard to wheezing, describing its importance, assessment methods, intervention types, and common questions.
What Conditions Can Cause Wheezing?
Wheezing is defined as a relatively loud sound that originates in the respiratory tract, while the obstruction in airflow is at any site. Various conditions can lead to wheezing.
- Asthma: A reversible airway inflammation and hyperreactivity.
- COPD: A preventable lung disorder characterized by airflow that progressively constraints in the lungs partially reversible with poor airflow. Its leading cause—smoking.
- Allergic reactions: An example is anaphylaxis. This can cause acute severe wheezing that occurs due to swelling in the bronchi brought about by the reaction.
- Infections: Furthermore, several infections of lower or upper respiratory tract can also cause wheezing. Also, it includes in the differential diagnosis of bronchitis and pneumonia.
Nursing Diagnosis for Wheezing Framework
Whenever an incidence of wheezing arises in a patient, a nurse shall conduct an extensive assessment before making any nursing diagnoses. NANDA is an association that standardizes nursing diagnoses to guide all nurses in developing care plans that best consider the safety of patients. Here are some nursing diagnoses that shall properly relate to a patient with wheezing:
1. Ineffective Airway Clearance
The inability to clear secretions or obstructions from the respiratory tract, which affects the patient’s ability to breathe deeply.
Related Factors:
- Excessive bronchial secretions
- Bronchospasm
- Mucosal edema
- Presence of foreign bodies
Defining Characteristics:
- Abnormal lung sounds (waffled, crackles)
- Ineffective coughing or inability to expectorate secretions
- Increased respiratory rate
- Signs of increased respiratory rate distress (e.g., use of accessory muscles)
Interventions:
- Assist the patient in doing deep breathing exercises and coughing techniques to promote secretion expectoration.
- Administer bronchodilators and mucolytics as doctors prescribed for reducing bronchospasm and easing the breakdown of.
- Continually assess patient’s respiratory status and oxygen saturation
2. Impaired Gas Exchange
This nursing diagnosis for wheezing involves limitation of the normal gas exchange of oxygen and carbon dioxide in the alveolar capillary membrane.
Related Factors.
- Obstruction of airway
- Destruction of alveolar capillary membrane
- V/Q mismatch
Defining Characteristics:
- Hypoxemia
- Hypoxia from hypoxemia
- Cyanosis, pallor
- Use of accessory muscles to breathe
Interventions:
- The nursing intervention in the care plan includes elevating the patient in a high Fowler’s position to facilitate lung expansion and improvement in gas exchange.
- Supplement oxygen as per prescription to achieve and facilitate optimal oxygen saturation levels.
- Teaching the patient to keep a patent airway and the early signs of not getting enough air.
3. Anxiety
Furthermore, a nursing diagnosis of wheezing involves a feeling of unease or apprehension that is often accompanied by respiratory distress.
Related Factors:
- Shortness of breath
- Fear that something harmful will happen to the patient
- History of problems related to the respiratory system
Defining Characteristics:
- Palpitations
- Tachypnea or tachypneic
- Expressiveness of feelings of panic or fear
- Restless or unable to be at rest
Interventions:
- The nurse should utilize therapeutic communication in giving comfort and support to the patient.
- Suggest relaxation exercises such as deep breathing, guided imagery/visualization, or mindfulness to decrease anxiety.
- Collaborate with the healthcare team to consider pharmacological options, such as anxiolytics, where appropriate.
4. Activity Intolerance
Furthermore, it also involves insufficient physiological or psychological energy to tolerate or to complete required or desired daily activities.
Related Factors:
- Dyspnea with exertion
- Fatigue from resp effort
- Musculoskeletal weakness due to prolonged inactivity
Defining Characteristics:
- Tachypnea with minimal exertion
- Patient expresses a desire to rest or avoid activity
- Weakness or fatigue with subjective patient reports
Interventions:
- Assist patients in breaking activities down to help alleviate shortness of breath and the inability to complete activities due to fatigue.
- Help with ADL as this provides comfort and promotes energy conservation.
- Establish a stepwise exercise program to be conducted with the available activity capacity using an activity level that is risen.
Nursing Care Planning Methods
An effective nursing diagnosis for a case of wheezing requires good planning and techniques.
- Obtaining a patient history: History of the patient gives information about pre-existing medical illnesses, previous medications, recent infections, and any settings.
- Physical Examination: A thorough examination of the respiratory system is done with prompt assessment for any lung pathology. This involves lung auscultation while at rest and while breathing deeply, visual assessment to check overall work of breathing, and state and condition of the chest.
- Monitoring Vital Signs: The health provider keeps a close lookout on the respiratory rate, heart rate, and oxygen saturation (SpO2) to avoid respiratory distress.
- Pulmonary Function Tests (PFTs): Nurses also performed such types of tests to get a clear picture of illness and its stage.
The nursing diagnosis for wheezing constitutes evidence based implementations targeting optimal airway clearance and gas exchange, further fostering the comfort of the patient.
Conclusion
Wheezing is an important clinical sign that mixes many illnesses of the respiratory system. Proper care, observation, and timely intervention are required to combat the issue. Nursing professionals can utilize the best possible care measures that ensure optimal patient outcomes through accurate diagnoses that consider the complexity of the underlying conditions. Moreover, the lives of such patients could be improved with this enriched understanding of wheezing. In this regard it is the nurses who would, of course, perform a very valuable function that include their knowledge, education, support, and advocacy. Also, not leaving out proper communication and the general philosophy of encompassing or holistic care.
FAQS
- What are the leading causes of wheezing?
Wheezing can result from various factors, such as but not limited to asthma, allergies, respiratory tract infections, COPD, and irritants present in the air of the environment like smoke and pollution.
- What is the diagnosis for wheezing?
Wheezing is diagnosed based on patient history, physical examination, and auscultation of lung sounds. Further diagnostic tests may sometimes be done to know the underlying cause, for example, chest X Rays or spirometry.
- Can wheezing be treated at home?
It may be controlled at home, and the medications can be administered, such as prescriptive inhalers. Patients need to be explained about their action plans; however, any worsening symptoms require immediate medical care.
- How can patients manage their wheezing at home?
Patients can control wheezing by identifying and avoiding the causative agents, adhering to prescribed medications, maintaining a general healthy life through diet and exercise, and keeping routine follow up appointments with their healthcare provider.
