Shortness of breath, or clinically termed dyspnea, is a common symptom that is usually encountered in all different settings of medical concerns, from the primary care clinic to the intensive care units. This involves the feelings of either breathlessness or an inability to take a satisfying breath.
Furthermore, it occurs for a short time but at times may signal an underlying medical condition requiring immediate attention. Due to this reason, nurses should employ appropriate nursing interventions for shortness of breath that help to relieve dyspnea. Additionally, it enhances physiological and psychosocial progress for the patient.
In this article we will discuss nursing interventions for the management of shortness of breath and also highlight the significance of providing care that is centered around the patient.
What is Shortness of Breath?
Shortness of breath can be due to a variety of causes; these include asthma, COPD, pneumonia, and pulmonary embolism. Dyspnea may also result from cardiovascular problems such as congestive heart failure and myocardial infarction. Anxiety and obesity are some of the non-medical reasons that may be attributed to increasing the feeling of shortness of breath.
Furthermore, the detailed history, physical examination, and investigation provide the underlying cause of dyspnea, which helps to identify the specific nursing care required.
Nursing Assessment
The nursing interventions cannot be generated without a proper, adequate assessment. A systematic assessment would contain the following components in carrying out an evaluation:
- Subjective Assessment: The patient is engaged in a question-and-answer session about the onset, duration of symptoms, and factors that exacerbate or relieve these symptoms. Moreover, utilizing a standardized tool, such as the Modified Medical Research Council Dyspnea Scale, would quantify the degree of dyspnea.
- Objective Assessment: Vital signs (heart rate, respiration rate, oxygen saturation) are taken, and a physical exam is conducted, with particular emphasis on the respiratory system. On auscultation of breath sounds, wheezing, crackles, or diminishment may indicate some pathology.
- Diagnostic Testing: Chest X-rays, arterial blood gases, and pulmonary function tests may be considered as appropriate diagnostic tests based on the physical assessment and presentation of dyspnea to find the cause of it.
Nursing Interventions for Shortness of Breath
There is no doubt that management of dyspnea is multilayered, both pharmacologic and nonpharmacologic. Below are some important nursing interventions for shortness of breath or for the relief of dyspnea.
- Positioning
Positioning is a simple measure to enhance respiratory function. Elevating the head of the bed can support an appropriate lung expansion and, subsequently, optimal gas exchange. The tripod position requires the patient to sit upright and lean forward while being supported.
This decreases dyspnea as it allows greater excursion of the diaphragm with an increase in lung volume. This places the patient in an anatomically favorable position, minimizing the work of breathing.
- Oxygen Therapy
In the case of confirmed or suspected hypoxemia, supplemental oxygen is provided in a manner that maintains optimal oxygen saturation levels, usually above 92%. It is preferably administered through modes of delivery by nasal cannula, simple mask, or non-rebreather mask and should be dictated by the severity of dyspnea and specific needs of the patient. Moreover, continuous monitoring of oxygen saturation is important in assessing response to therapy.
- Pharmacological Therapy
Dyspnea may require medication depending on the cause. For a diagnosis of bronchospasm in asthma or COPD, bronchodilators such as albuterol are effective and may be given using metered-dose inhalers or nebulizers. Corticosteroids may be ordered to decrease inflammation and bronchoconstriction. Diuretics are also used to decrease dyspnea in patients with fluid overload due to congestive heart failure.
4. Breathing Techniques
Furthermore, teaching controlled breathing techniques may aid the patient’s present ability to manage symptoms. These techniques, which serve to induce relaxation and thereby optimize ventilation, include the use of pursed-lip breathing and diaphragmatic breathing. Moreover, pursed-lip breathing involves inhaling through the nose and exhaling slowly through pursed lips; this type of breathing can help minimize dyspnea during activity.
5. Modification of Environment
When a person experiences breathlessness mainly he needs to be out in an easily breathable environment. Therefore, nursing interventions for shortness of breath ensure good ventilation around the patient and eliminate all possible allergens and irritants. This can be complemented by encouraging a quiet environment, where loudness may raise anxiety and further discomfort for the patients.
6. Emotional Support and Education
Dyspnea is, by nature, emotionally disturbing; therefore, care should be holistic. Anxiety is one of the factors that may exacerbate the sensation of breathlessness; hence, reassurance and establishment of therapeutic rapport are necessary.
Further explanation on the nature of dyspnea, its etiology, and the management approach must be made available to both the patient and the family. This builds the active participation of the patient in care and enhances compliance to treatment plans.
7. Regular Monitoring and Evaluation
Monitor the patient’s respiratory status continuously to evaluate the effectiveness of the interventions taken and any decline in the patient’s condition. Measure dyspnea using a consistent, standard dyspnea assessment tool. Revise the plan of care based on the patient’s responses to the interventions delivered.
8. Coordinating with the Health Care Team
An interprofessional approach is of the essence in managing and in the nursing intervention of shortness of breath. Moreover, a collaboration with respiratory therapists and physicians, among other healthcare professionals, can facilitate care in ensuring comprehensive management of the problem to meet the unique needs of the patient. Indeed, this regular communication about the status of the patient and changes in their condition can maximize treatment outcomes.
Final Verdict
The management of shortness of breath requires a careful understanding of specific nursing interventions. It involves the front-line service of nurses in the assessment, management, and education of dyspnea patients through various interventions. The nurses can ensure increased patient comfort and enhanced health outcomes through comprehensive methods such as pharmacological treatment, modification of the environment, assurance of emotional support, and collaboration with interprofessional staff. Relief of dyspnea is, therefore, effective for the comfort of a patient and further strengthens the compassion and effectiveness which are characteristics of nursing care.
FAQs
- How do you handle a patient with shortness of breath?
Nurses should check a person’s airways, pulse, as well as breathing. On the other hand, if CPR is necessary then do it. Also, help patients to take their prescribed medicine.
- What intervention can help a person with shortness of breath?
The most important thing is breathing control exercises or breathing training. Moreover, cool air, body position exercises, chest wall vibrations, etc will also work in such conditions.
- How to relieve chest tightness and shortness of breath?
Take a deep breath through your nose and exhale from your mouth. Take cold air from the fan. Try to learn relaxation techniques to get quick relief.
