Treatments for Asphyxia
Treatments for Asphyxia
The list of treatments mentioned in various sources
for Asphyxia
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- First aid to remove foreign body
- Emergency rescuscitation
- Expired Air Rescuscitation (EAR)
- Cardio-Pulmonary Rescuscitation (CPR)
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Dyspnea:
Treatment
(In a Page: Signs and Symptoms)
-
Attention to airway, breathing, and circulation
-
Administer supplemental O2 as needed
-
Asthma: Avoid triggers; bronchodilation with inhaled β
2
agonists (e.g., albuterol) and anticholinergics
(e.g., ipratropium); inhaled, oral, and/or IV steroids
-
COPD: Inhaled bronchodilators (e.g., albuterol, ipratropium); systemic corticosteroids; antibiotics (e.g., azithromycin, doxycycline) in severe exacerbations; mechanical ventilation (CPAP or BiPAP)
-
Cardiogenic pulmonary edema: Vasodilators (e.g., IV nitroglycerin, ACE inhibitors), loop diuretics (e.g., IV furosemide), morphine, digoxin, and/or inotropes
-
Noncardiogenic edema generally requires only supportive care; treat underlying etiology (e.g., surgical correction of valvular lesions)
-
Pleural effusion: Address underlying cause; diagnostic or therapeutic thoracentesis may be indicated; pleurodesis for recurrent effusions
-
Pneumothorax: 100% O2 accelerates resorption
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Source: In a Page: Signs and Symptoms, 2004
Orthopnea:
Treatment
(In a Page: Signs and Symptoms)
-
Attention to airway, breathing, and circulation
-
Administer supplemental O2 as needed
-
CHF: Decrease preload by venodilation and afterload by arteriodilation and volume removal, to improve forward blood flow and decrease symptoms; give nitrates (sublingual/IV), loop diuretics, IV morphine, ACE inhibitors, digoxin, spironolactone; treat refractory respiratory distress with CPAP, BiPAP, or intubation
-
Valvular disease: Reduce blood pressure with an ACE inhibitor or β-blocker; surgery (balloon valvuloplasty, valve repair, or valve replacement) for severe disease
-
Pleural effusion: Treat underlying cause; thoracentesis may be indicated; pleurodesis for recurrent effusions
-
Asthma: Avoid triggers; bronchodilation with inhaled βagonists (e.g., albuterol) and anticholinergics (e.g., ipratropium); inhaled, oral, and/or IV steroids
-
COPD: Inhaled bronchodilators (e.g., albuterol, ipratropium); systemic corticosteroids; antibiotics in severe exacerbations; mechanical ventilation
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Paroxysmal Nocturnal Dyspnea:
Treatment
(In a Page: Signs and Symptoms)
-
Attention to airway, breathing, and circulation
-
Administer supplemental O2
-
Many patients feel relief with cold air blowing in face
-
CHF: Mainstay of therapy is to decrease preload (by venodilation) and afterload (by arteriodilation and volume removal) to improve forward blood flow and decrease symptoms; nitrates (sublingual and IV), loop diuretics, IV morphine, ACE inhibitors, and spironolactone; treat refractory respiratory distress with CPAP, BiPAP, or intubation
-
Valvular disease: Blood pressure reduction with an ACE inhibitor or β-blocker is first-line therapy; surgical
intervention (balloon valvuloplasty, valve repair, or valve
replacement) is needed for severe disease
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Source: In a Page: Signs and Symptoms, 2004
Stridor & Wheezing:
Treatment
(In a Page: Signs and Symptoms)
-
Attention to airway, breathing, and circulation
-
Administer supplemental O2
-
Asthma: Avoid triggers; bronchodilation with inhaled β
2
agonists (e.g., albuterol) and anticholinergics (e.g., ipratropium); inhaled, oral and/or IV steroids
-
Epiglottitis: Emergent airway intervention (endotracheal intubation or tracheostomy); cephalosporin antibiotics
-
Respiratory infection: Appropriate antibiotics if bacterial cause is suspected; βagonists
-
Anaphylaxis: Patients in extremis require immediate subcutaneous epinephrine injection; antihistamines (e.g., diphenhydramine); inhaled β
2 agonists
(e.g., albuterol); steroids
-
Croup: Supportive care; nebulized steroids; epinephrine
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Source: In a Page: Signs and Symptoms, 2004
Apnea:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Central apnea therapy depends on cause; an infant may need no more than monitoring or supplemental O2.
-
Severe central apnea, especially with respiratory muscle failure, may need to be treated with artificial respiration (via nasal/face mask or tracheotomy tube)
-
CCHS may be treated long term with diaphragmatic pacing
-
Other causes of central apnea require targeted therapy (i.e., antibiotics for sepsis, O2 for severe hypoxia)
-
Severe obstruction is bypassed with tracheostomy, or overcome with positive pressure ventilation
-
Weight loss is an important adjunct in treating severe OSAS
-
Respiratory stimulants (e.g., caffeine) may help some babies with apnea of prematurity
-
Vigorously treat causative factors (e.g., GERD)
-
Apnea monitors are of little proven value in the management or treatment of apnea, yet frequently used
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Source: In A Page: Pediatric Signs and Symptoms, 2007
Dyspnea:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Dyspnea is a sign of respiratory distress, but it is not treated with sedation (increases risk of respiratory failure or arrest)
-
Oxygen
–First line in the treatment of hypoxia
–Use caution if it is accompanied by hypercapnea (as in chronically cyanotic patients or with COPD), because the respiratory effort may be driven by the hypoxia, and there will be a decrease in respiratory drive leading to increases in PaCO2(rare in children unless there is CCHD)
-
Airway lesions may require intervention to provide relief; target underlying illnesses (e.g., treat pneumonia with antibiotics) but persist in efforts to improve mechanics (e.g., chest physiotherapy to clear secretions)
-
Surgical stabilization of abnormal chest wall or of anatomic abnormality
-
Asthma therapy may provide relief even when asthma is not the “primary” problem (e.g., muscular dystrophy)
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Source: In A Page: Pediatric Signs and Symptoms, 2007
Stridor:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treatment is frequently based on diagnosis from endoscopy
-
Immediate evaluation when respiratory distress is present
–Observation, intubation, tracheostomy, FB removal
-
Acute stridor
–Viral laryngotracheobronchitis: Steroids, racemic epinephrine, and supplemental O2
–Bacterial tracheitis: Culture-directed antibiotic therapy, consider intubation
-
Chronic stridor of newborn
–History, physical, and endoscopy (fiberoptic or direct)
confirmation of laryngomalacia
–Consider treatment for reflux
–Repeat endoscopy and possible supraglottoplasty if
persistent stridor and failure to thrive
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Source: In A Page: Pediatric Signs and Symptoms, 2007
Apnea:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If you detect apnea, first establish and maintain a patent airway. Position the patient in a supine position and open his airway using the head-tilt, chin-lift technique. (Caution: If the patient has an obvious or suspected head or neck injury, use the jaw-thrust technique to prevent hyperextending the neck.) Next, quickly look, listen, and feel for spontaneous respiration; if it’s absent, begin artificial ventilation until it occurs or until mechanical ventilation can be initiated.
Because apnea may result from cardiac arrest (or may cause it), assess the patient’s carotid pulse immediately after you’ve established a patent airway. Or, if the patient is an infant or small child, assess the brachial pulse instead. If you can’t palpate a pulse, begin cardiac compression.
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Source: Handbook of Signs & Symptoms (Third Edition), 2006
Bradypnea:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
Depending on the degree of central nervous system (CNS) depression, the patient with severe bradypnea may require constant stimulation to breathe. If the patient seems excessively sleepy, try to arouse him by shaking and instructing him to breathe. Quickly take the patient's vital signs. Assess his neurologic status by checking pupil size and reactions and by evaluating his level of consciousness (LOC) and his ability to move his extremities.
Place the patient on an apnea monitor and pulse oximeter, keep emergency airway equipment available, and be prepared to assist with intubation and mechanical ventilation if spontaneous respirations cease. To prevent aspiration, position the patient on his side or keep his head elevated 30 degrees higher than the rest of his body, and clear his airway with suction or finger sweeps, if necessary. Administer opioid antagonists, as ordered.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Stridor:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If you hear stridor, quickly check the patient’s vital signs, including oxygen saturation, and examine him for other signs of partial airway obstruction — choking or gagging, tachypnea, dyspnea, shallow respirations, intercostal retractions, nasal flaring, tachycardia, cyanosis, and diaphoresis. (Be aware that abrupt cessation of stridor signals complete obstruction in which the patient has inspiratory chest movement but absent breath sounds. Unable to talk, he quickly becomes lethargic and loses consciousness.)
If you detect signs of airway obstruction, try to clear the airway with back blows or abdominal thrusts (Heimlich maneuver). Next, administer oxygen by nasal cannula or face mask, or prepare the patient for emergency endotracheal (ET) intubation or tracheostomy and mechanical ventilation. (See Emergency endotracheal intubation.) Have equipment ready to suction aspirated vomitus or blood through the ET or tracheostomy tube. Connect the patient to a cardiac monitor, and position him upright to ease his breathing.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Asphyxia:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
CPR, intubation and mechanical ventilation, bronchoscopy, opioid antagonist, gastric lavage
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Apnea:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If you detect apnea, first establish and maintain a patent airway. Place the patient in a supine position, and open his airway using the head-tilt, chin-lift technique. (Caution: If the patient has or may have a head or neck injury, use the jaw-thrust technique to prevent hyperextending the neck.) Next, quickly look, listen, and feel for spontaneous respiration; if it’s absent, begin artificial ventilation until it occurs or until mechanical ventilation can be initiated.
Because apnea may result from (or may cause) cardiac arrest, assess the patient’s carotid pulse immediately after you’ve established a patent airway. Or, if the patient is an infant or small child, assess the brachial pulse instead. If you can’t palpate a pulse, begin cardiac compression.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Bradypnea:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Depending on the degree of central nervous system (CNS) depression, a patient with severe bradypnea may require constant stimulation to breathe. If the patient seems excessively sleepy, try to arouse him by shaking him and instructing him to breathe. Quickly take the patient’s vital signs. Assess his neurologic status by checking pupil size and reactions and by evaluating his level of consciousness (LOC) and his ability to move his extremities.
Connect the patient to an apnea monitor, keep emergency airway equipment available, and be prepared to assist with intubation and mechanical ventilation if spontaneous respirations cease. To prevent aspiration, position the patient on his side or keep his head elevated 30 degrees higher than the rest of the body, and clear his airway with suction or finger-sweeps if necessary.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Dyspnea:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If a patient complains of shortness of breath, quickly look for signs of respiratory distress, such as tachypnea, cyanosis, restlessness, and accessory muscle use. Prepare to administer oxygen by nasal cannula, mask, or endotracheal tube. Ensure patent I.V. access, and begin cardiac monitoring and oxygen saturation monitoring to detect arrhythmias and low oxygen saturation, respectively. Expect to insert a chest tube for severe pneumothorax and to administer continuous positive airway pressure (CPAP).
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Orthopnea:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Instruct the patient to notify the physician if he’s using additional pillows regularly, or if dyspnea worsens at night.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Stridor:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If you hear stridor, quickly check the patient’s vital signs including oxygen saturation and examine him for other signs of partial airway obstruction—choking or gagging, tachypnea, dyspnea, shallow respirations, intercostal retractions, nasal flaring, tachycardia, cyanosis, and diaphoresis. (Be aware that abrupt cessation of stridor signals complete obstruction in which the patient has inspiratory chest movement but absent breath sounds. Unable to talk, he quickly becomes lethargic and loses consciousness.)
If you detect any signs of airway obstruction, try to clear the airway with back blows or abdominal thrusts (Heimlich maneuver). Next, administer oxygen by nasal cannula or face mask, or prepare for emergency endotracheal intubation or tracheostomy and mechanical ventilation. (See Emergency endotracheal intubation, page 734.) Have equipment ready to suction any aspirated vomitus or blood through the endotracheal or tracheostomy tube. Connect the patient to a cardiac monitor, and position him upright to ease his breathing.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Asphyxia:
Treatment
(Handbook of Diseases)
Asphyxia requires immediate respiratory support — with cardiopulmonary resuscitation, endotracheal intubation, and supplemental oxygen as needed. The underlying cause must be remedied: bronchoscopy for extraction of a foreign body; a narcotic antagonist, such as naloxone, for narcotic overdose; gastric lavage for poisoning; and limited, graded use of supplemental oxygen for carbon dioxide narcosis caused by excessive oxygen therapy.
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Source: Handbook of Diseases, 2003
Apnea:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Perform continuous assessment of the patient’s respiratory and cardiac systems until he’s stable. Obtain his vital signs, and perform a full neurologic examination.
Patient teaching
If the cause of the apnea was preventable, review the standards with the patient, if applicable, and his family. Educate the patient about safety measures related to aspiration of medications. Encourage cardiopulmonary resuscitation training for all adolescents and adults.
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Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Bradypnea:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Because a patient with bradypnea may develop apnea, check his respiratory status frequently and be prepared to give ventilatory support if necessary. Don’t leave the patient unattended, especially if his LOC is decreased. Obtain blood for arterial blood gas analysis, electrolyte studies, and a possible drug screen. Ready the patient for chest X-rays and possibly a computed tomography scan of the head.
Administer prescribed drugs and oxygen. Administration of I.V. nalozone, an opioid antagonist, may be required depending on the cause of the respiratory depression. Avoid giving the patient a CNS depressant because it can exacerbate bradypnea. Similarly, give oxygen judiciously to a patient with chronic carbon dioxide retention, which may occur with chronic obstructive pulmonary disease, because excess oxygen therapy can have a negative effect.
When dealing with slow breathing in hospitalized patients, always review all drugs and dosages given during the last 24 hours.
Patient teaching
Inform the patient who regularly takes an opioid — for example, a patient with advanced cancer or sickle cell anemia — that bradypnea is a serious complication. Teach him the early signs of toxicity, such as nausea and vomiting. It’s also important to identify the patient who may be abusing these drugs.
Encourage the family to take a cardiopulmonary resuscitation class.
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Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Dyspnea:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Monitor the dyspneic patient closely. Be as calm and reassuring as possible to reduce his anxiety, and help him into a comfortable position — usually high Fowler’s or forward-leaning position. Support him with pillows, loosen his clothing, and administer oxygen if appropriate.
Prepare the patient for diagnostic studies, such as arterial blood gas analysis, chest X-rays, and pulmonary function tests. Administer a bronchodilator, an antiarrhythmic, a diuretic, and an analgesic, as needed, to dilate bronchioles, correct cardiac arrhythmias, promote fluid excretion, and relieve pain.
Patient teaching
Tell the patient that oxygen therapy isn’t necessarily indicated for dyspnea. Encourage a patient with chronic dyspnea to pace his daily activities. Teach him about pursed-lip, diaphragmatic breathing and chest splinting. Instruct him to avoid chemical irritants, pollutants, and people with respiratory infections and discuss the importance of pneumococcal vaccination and influenza vaccination. Refer him to a respiratory therapist, as appropriate.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Hyperpnea:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Monitor vital signs including oxygen saturation in all patients with hyperpnea, and observe for increasing respiratory distress or an irregular respiratory pattern signaling deterioration. Prepare for immediate intervention to prevent cardiovascular collapse: Start an I.V. line for administration of fluids, blood transfusions, and vasopressor drugs for hemodynamic stabilization, as ordered, and prepare to give ventilatory support. Prepare the patient for arterial blood gas analysis and blood chemistry studies.
Patient teaching
Teach the patient how to monitor his blood sugar level. Stress the importance of compliance with diabetes therapy, if applicable. Provide information on fluids and foods the patient should avoid. Discuss pulmonary hygiene and teach the patient ways to avoid respiratory infections. Emphasize the importance of abstinence from alcohol; refer to support groups or other resources that can assist, if indicated.
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Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Stridor:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Continue to monitor the patient’s vital signs closely. Prepare him for diagnostic tests, such as arterial blood gas analysis and chest X-rays. Offer reassurance and calm the patient and his family. Provide ongoing assessment of the patient’s respiratory status and oxygenation.
Patient teaching
Instruct the patient and his family about safety measures in the home environment if the stridor is related to aspiration of a foreign object. If the stridor is related to croup, teach the parents techniques to use to manage the condition. Teach the patient and his family about signs and symptoms that require immediate attention.
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Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Bradypnea:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Depending on the degree of central nervous system (CNS) depression, the patient with severe bradypnea may require constant stimulation to breathe. If he seems excessively sleepy, try to arouse him by shaking and instructing him to breathe. Quickly take the patient’s vital signs. Assess his neurologic status by checking pupil size and reactions and by evaluating his level of consciousness (LOC) and his ability to move his extremities.
Place the patient on an apnea monitor, keep emergency airway equipment available, and be prepared to assist with intubation and mechanical ventilation if spontaneous respirations cease. To prevent aspiration, position the patient on his side or keep the head elevated 30 degrees higher than the rest of the body, and clear his airway with suction or finger-sweeps, if necessary.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Dyspnea:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If a patient complains of shortness of breath, quickly look for signs of respiratory distress, such as tachypnea, cyanosis, restlessness, and accessory muscle use. Prepare to administer oxygen by nasal cannula, mask, or endotracheal tube. Ensure patent I.V. access, and begin cardiac monitoring and oxygen saturation monitoring to detect arrhythmias and low oxygen saturation, respectively. Expect to insert a chest tube for severe pneumothorax and to administer continuous positive airway pressure or apply rotating tourniquets for pulmonary edema.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hyperpnea:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient with diabetes to monitor blood glucose levels. Encourage strict adherence to the therapy prescribed for his diabetes. Encourage the patient with renal disease to limit fluids and maintain a low-protein, low-sodium, low-potassium, low-phosphorus, high-calorie, high-carbohydrate diet. For the patient with pulmonary disease, discuss how to maintain pulmonary hygiene and avoid respiratory infections.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Orthopnea:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Instruct the patient to notify the physician if he’s using additional pillows regularly or if dyspnea worsens at night. Teach him to follow a low-sodium diet and to limit fluids. Tell him to weigh himself daily and to report a weight gain of 1⅛ to 2¼ lb (0.5 to 1 kg) in one day.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Stridor:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If you hear stridor, quickly check the patient’s vital signs including oxygen saturation and examine him for other signs of partial airway obstruction — choking or gagging, tachypnea, dyspnea, shallow respirations, intercostal retractions, nasal flaring, tachycardia, cyanosis, and diaphoresis. (Be aware that abrupt cessation of stridor signals complete obstruction in which the patient has inspiratory chest movement but absent breath sounds. Unable to talk, he quickly becomes lethargic and loses consciousness.)
If you detect any signs of airway obstruction, try to clear the airway with back blows or abdominal thrusts (Heimlich maneuver). Next, administer oxygen by nasal cannula or face mask, or prepare for emergency endotracheal intubation or tracheostomy and mechanical ventilation. Have equipment ready to suction any aspirated vomitus or blood through the endotracheal or tracheostomy tube. Connect the patient to a cardiac monitor, and position him upright to ease breathing.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Apnea:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Closely monitor the patient's cardiac and respiratory status to prevent further episodes of apnea.
▪ Provide oxygen and ventilation as necessary, and monitor arterial blood gases and pulse oximetry for effectiveness.
Patient teaching
▪ Explain the underlying cause and treatment plan.
▪ Teach safety measures to reduce the risk of aspiration.
▪ Encourage the patient's family to learn cardiopulmonary resuscitation.
▪ Teach ways to decrease or avoid episodes of apnea, based on its cause.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Bradypnea:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Check the patient's respiratory status frequently and be prepared to give ventilatory support if necessary.
▪ Don't leave the patient unattended, especially if his LOC is decreased.
▪ Obtain blood for arterial blood gas analysis, electrolyte studies, and a possible drug screen.
▪ Ready the patient for chest X-rays and, possibly, a computed tomography scan of the head.
▪ Administer prescribed drugs and evaluate their effect.
▪ Avoid giving a CNS depressant because it can exacerbate bradypnea.
▪ Administer oxygen, being judicious in the patient with chronic carbon dioxide retention (such as chronic obstructive pulmonary disease) because excess oxygen therapy can decrease respiratory drive.
▪ Review all drugs and dosages given during the last 24 hours.
Patient teaching
▪ Explain the complications of opioid therapy such as bradypnea.
▪ Discuss the signs and symptoms of opioid toxicity.
▪ Teach the patient about the cause of bradypnea and the treatment plan after a diagnosis is established.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Dyspnea:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the patient with dyspnea closely.
▪ Be calm and reassuring to reduce the patient's anxiety.
▪ Position the patient comfortably, usually high Fowler's or the forward-leaning position.
▪ Administer oxygen if needed and monitor pulse oximetry.
▪ Prepare the patient for diagnostic studies, such as arterial blood gas analysis, chest X-rays, and pulmonary function tests.
▪ Administer a bronchodilator, an antiarrhythmic, a diuretic, and an analgesic, as needed, to dilate bronchioles, correct cardiac arrhythmias, promote fluid excretion, and relieve pain.
Patient teaching
▪ Teach the patient pursed-lip breathing, diaphragmatic breathing, and chest splinting.
▪ Instruct the patient to avoid chemical irritants, pollutants, and people with respiratory infections.
▪ Explain the underlying causes of his dyspnea and the treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Hyperpnea:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor vital signs, including oxygen saturation.
▪ Observe for increasing respiratory distress, an irregular respiratory pattern, or hypoxia—all of which signal deterioration.
▪ Start an I.V. line for administration of fluids, blood transfusions, and vasopressor drugs for hemodynamic stabilization, as ordered.
▪ Prepare to give ventilatory support.
▪ Obtain arterial blood gas analysis and blood chemistry studies, as ordered.
Patient teaching
▪ Teach the patient to monitor his blood glucose level, if appropriate.
▪ Stress the importance of compliance with diabetes therapy, if applicable.
▪ Explain any food and fluid restrictions.
▪ Teach the patient coughing and deep-breathing exercises.
▪ Discuss ways to avoid respiratory infection.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Orthopnea:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ To relieve orthopnea, place the patient in semi-Fowler's or high Fowler's position.
▪ Alternatively, have the patient lean over a bedside table with his chest forward.
▪ Administer oxygen via nasal cannula, if indicated.
▪ Administer a diuretic, if needed.
▪ For the patient with left-sided heart failure, give angiotensin-converting enzyme inhibitors, unless contraindicated.
▪ Monitor intake and output.
▪ Prepare the patient for diagnostic testing, such as an electrocardiogram, chest X-ray, pulmonary function tests, and arterial blood gas analysis.
▪ Assist with insertion of a central venous catheter or pulmonary artery catheter to measure central venous pressure and pulmonary artery wedge pressure and cardiac output, respectively.
Patient teaching
▪ Explains signs and symptoms that require prompt medical attention.
▪ Discuss any dietary and fluid restrictions.
▪ Reinforce the need to monitor weight daily.
▪ Explain diagnostic tests, diagnosis, and treatment plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Stridor:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the patient's vital signs closely.
▪ Prepare him for diagnostic tests, such as arterial blood gas analysis and chest X-rays.
▪ Administer oxygen and monitor airway and ventilation.
▪ Provide emotional support.
Patient teaching
▪ Explain the underlying disorder and treatment.
▪ Explain to the patient all procedures and treatments.
▪ Stay with the patient and talk to him in a calm voice to reduce anxiety.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Paroxysmal nocturnal dyspnea:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, such as a chest X-ray, echocardiography, exercise electrocardiography, and cardiac blood pool imaging.
▪ If the hospitalized patient experiences paroxysmal nocturnal dyspnea, assist him to a sitting position or help him walk around the room.
▪ If necessary, provide supplemental oxygen.
▪ Keep the patient calm because anxiety can exacerbate dyspnea.
Patient teaching
▪ Explain signs and symptoms that require immediate medical attention.
▪ Discuss dietary and fluid restrictions the patient requires.
▪ Talk about positions that can ease breathing.
▪ Teach the patient about prescribed medications, their dosage, administration, and adverse effects.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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