Dyspnea

AHAMMED NASEEM
BSc Nursing Student
 DEFINITION
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