Dyspnea
AHAMMED NASEEM
ROLL NO : 3
SECOND YEAR BSC NURSING
AL-MAS COLLEGE OF NURSING
Dyspnea
Dyspnea is defined as difficult or laboured breathing
or the unpleasant awareness of ones breathing
American Thoracic society Defines Dyspnea as ;
subjective experience of breathing discomfort that consist
of qualitatively distinct sensation that vary in intensity
experience derives from interactions among multiple
physiological, Psychological, Social & environmental factors
And may include secondary Physiological and behavioral
responses"
ETIOLOGY
Pulmonary Causes
1. COPD
2. Asthma
3. Restrictive Lung Disorder
4. Pneumonia
5. Pneumothorax
Cardiac Causes
1. Congestive heart failure
2. coronary artery disease
3. Recent or past history of mi
4. cardiomyopathy
5. valvular dysfunction
6. Left Ventricular hypertrophy
7. pericarditis
8. Arrhythmias
Mixed Cardiopulmonary Causes
1. COPD with pulmonary HTN or Cor-pulmonale
2. Deconditioning
3. Chronic Pulmonary emboli
4. Pleural Effusion
Non Cadio-Pulmonary Causes
1. Metabolic Conditions like acidosis
2. pain
3. trauma
4. Neuromuscular Disorders
5. Functional (anxiety, panic, hyperventilation)
6. chemical exposure
7. Anemia
PATHOPHYSIOLOGY
• Dyspnea results when there is an imbalance between the
perceived ability to breathe
• CO2 build-up & O2 deprivation were the critical factors that results
in dyspnea
• O2 Saturation in insensitive in identifying patients with Dyspnea
• elevations in CO2 levels appear to stimulate dyspnea more than
do low O2 Level
• Respiratory efforts is believed to originate as a single transmitted
from motor cortex simultaneously to sensory cortex and to the
motor command to ventilatory muscles the brain stem may also
contribute to the sense of efforts
• The perception of air hunger is believed to arise in part
from increased respiratory activities within the brain
stem
• sensation of chest tightness probably results from
stimulation of vagal irritants receptors
RISK FACTORS
o Chemicals
o Heart attack & Failure
o Fumes o Panic attack
o Dusts
o allergens like pollen
o smoking
o severe exercise
o Asthma
o pneumonia
o chocking
o pulmonary embolism (Blood Clots in lungs)
CLINICAL MANIFESTATIONS
• Cough
• Anxiousness
• Chest pain and tightness
• Dizziness
• Fainting
• Fatigue
• Laboured Breathing
• Rapid and Shallow Respiration
TYPES OF DYSPNEA
Depending On the onset
Acute Dyspnea:- Feels shortness of breath suddenly and it
might accompanied with other symptoms like cough
Chronic Dyspnea:-Feel out breath while doing simple
everyday tasks, It is long lasting & usually due to some
underlying chronic diseases
Depending On the Position
Nocturnal Dyspnea:-Dyspnea which only at night & may
be proximal as in patient with heart failure
Orthopnea:-Dyspnea Occurs When a patient lies down
as in case with heart failure , asthma & Chronic
obstructive Pulmonary Disease
Trepopnea:-This is the appearance of breathlessness
only in the left & right lateral positions. The doesn't
occur when patient in the supine position, this occurs in
patients with heart disease
Platypnea:-This is breathlessness which occurs only in
upright position
DIAGNOSIS
o Chest Radiography
o Electrocardiography
o Screening Spirometry
o Complete Pulmonary Function Test
o Arterial Blood gas analysis
o Standard exercise treadmill testing or complete cardio
pulmonary exercise testing
o Physical examination (General appearance, vital signs,
Auscultate, respiratory sounds, Cyonosis)
FIRST AID
DO'S
• Call the local emergency
• Check the airway breathing and pulse
• Begin CPR if necessary
• Help person to use any prescribed medication
• Monitor Breathing and pulse
• Open wound in neck of chest must be closed
Don't Do's
• Don't give the person food & drink
• Don't move the person if there has been a chest or airway
injury unless it is absolutely necessary
• Don't place a pillow under the person's head this can close the
airway
• Don't wait to see if person's condition improves before getting
medical help get help immediately
MEDICAL MANAGEMENT
• The primary management directed at its underlying cause
• Chemotherapy/Radiation therapy may shrink the tumor to
lessen the dyspnea
• If dyspnea is being caused by an infection , antibiotics
may be needed
PHARMACOLOGICAL
MANAGEMENT
• Bronchodilator:- Open the patient's airway & decrease
their dyspnea
• Steroids:-Help reduce swelling in the lungs that may be
causing the shortness of breath
• Anti-anxiety Drugs:-Can help break the cycle of panic that
can lead to more breathing difficulties
• Pain Medications:- can make breath easier
NURSING MANAGEMENT
• Place the patient at the position in which the patient can
breath property
• Encourage sustained deep breathing
• Encourage diaphragmatic breathing for patients with
chronic diseases
• Provide respiratory Medications and O2 as per order
• Maintain clear airway by entourage coughing or Suction
• Stay with patient during acute episodes of respiratory
distress
• Encourage Frequent rest periods & teach patient to pace
activity
• Avail Fan in room
• Patient and family education
