dyspnea
Dyspnea is defined as a feeling not comfortable or unpleasant sensation of respiration, is a common symptom in patients with cardiopulmonary disorders (Manning & Mahler, 2001). The major sign and symptom perceived by the patient that affected by chronic respiratory disease is breathlessness or dyspnea. Besides, a common problem affecting up to half of patients permitted to a minor, tertiary care hospitals and one quarter of ambulatory patients is dyspnea (Parshall, et.al, 2012).
In the scope of cardiopulmonary disease, the five expressive group in the language of dyspnea most regularly choosen are ‘chest tightness’, ‘increased effort of breathing’, ‘unsatisfied inspiratory effort’, ‘rapid or superficial breathing’ and ‘breathlessness’. For asmatic patients, they usually complain of feeling chest tightness. Meanwhile, patients that always give excuse about increase in work or breathing usually associated with weakness of respiratory muscle and chronic obstructive pulmonary disease (COPD). During high intensity physical exercise or external chest restriction, people often experience of ‘rapid or shallow breathing’. (Crisafulli & Clini, 2009)
Eventhough dyspnea is a common symptom of respiratory disability or complication, there are certain languages or terms of dyspnea that describe the conditions (Manning & Mahler, 2001). Varieties mechanisms likely give rise to qualitatively different sensations of dyspnea. Research of the language of dyspnea suggests that this symptom represents a statistic of qualitatively definite sensations, and that the words used by patients to illustrate their breathing problem may give insight into the underlying pathophysiology of the disease. The conscious awareness of voluntary activation of s...
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...ppened because of anaemia. Anaemia, which is a low level of oxygen in the blood due to a lack of red blood cells or lack of haemoglobin heart failure, which means the heart is in trouble pumping enough blood to the entire body, usually because the heart muscle has become too weak or stiff to work properly a problem with heart rate or rhythm, such as atrial fibrillation (NHS, 2013). Anaemia is a condition of insufficient haemoglobin in the blood to distribute oxygen to body cells. This causes dullness, tiredness and hunger of air. Heavy menstrual periods is the most common cause in the united Kindom (UK). In older people,the common cause is bleeding into the gut (Robinson, 2013). One of the other long-term breathlessness is usually caused by obesity or being lack of fitness. The fat tissues that cover the body affect the rate of distribution of air through the body.
The contraction of the inspiratory muscles increases the volume of the thoracic cavity causing the pressure within the alveoli to decrease and air to flow into the alveoli. During resting inspiration, the diaphragm, the external intercostals and the parasternal intercostals contract to stimulate inspiration. During forced inspiration the scalene and the sternocleidomastoid muscles contract to further expand the thoracic cavity. The pectoralis minor muscles also play a minor role in forced inspiration. During quiet breathing, relaxation of these muscles causes the volume of the thoracic cavity to decrease, resulting in expiration. During a forced expiration, the compression of the chest cavity is increased by contraction of the internal intercostal muscles and various abdominal
Chronic obstructive pulmonary disease, better known as COPD, is a disease that affects a person’s ability to breathe normal. COPD is a combination of two major lung diseases: emphysema and chronic bronchitis. Bronchitis affects the bronchioles and emphysema affects the alveoli.
WEST, N and POPKESS-VAWTER, S (1994) The subjective and psychosocial nature of breathlessness. Journal of Advanced Nursing. 20 p622.
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
When diagnosed with hyponatremia treatment usually immediately begins. Treatment must be a restriction of both salt and water (Gheorghita et. al 2010). Hyponatremic patients must receive a slow increase in sodium with a restriction of liquids. Intravenous hypertonic saline solution of 3% NaCl can be administered to patients who have been diagnosed with hyponatremia. There is a precise formula that is used in determining the quantity of NaCl that is used in increasing sodemia and the rate at which it should be administered (Gheorghita et. al 2010).
The ability to swallow is an intricate process that includes the coordinated effort of cranial nerves and multiple muscles. Pathophysiology of aspiration is such that, food or liquid is misdirected down the respiratory pathway. In most cases aspiration will occur as it travels via the straighter path to the right main bronchus and onward to the right lower lobe of the lung (Eisenstadt, 2010). Dysphagia’s incidence after a stroke varies due to the location of the stroke and occurs between 28%-79% of the time (Lakshminarayan et al., 2010). Current state has bodies of authority without an approved dysphagia measure based on evidenced. These entities hospitals would look to for consensus and guidance are the American Heart Association (AHA), Centers for Disease Control (CDC), and The Joint Commission (TJC) (Solis, n.d.). Without the endorsement of a screening tool, hospitals may not be persistently utilizing a dys...
Chronic obstructive pulmonary disease (COPD) is an umbrella term used to refer to chronic, progressive diseases affecting the respiratory system including chronic bronchitis and emphysema. COPD is characterised by inflammation, loss of muco-ciliary clearance, fibrosis and loss of elastic recoil in the lung parenchyma. Inflammation increases mucous secretions that cannot be efficiently cleared from the airway due to the destruction of cilia. Damage to lungs and excessive mucous reduces airflow, gas exchange and expiratory volume leading to gas trapping. These changes cause the patient to develop the dyspnoea, cough and sputum production characteristic of COPD (Burt & Corbridge, 2013, p. 34-35).
Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992). The diagnosis of COPD is predominantly based on the results of a lung function assessment (Larsson, 2007). Chronic bronchitis is differentiated from emphysema by it's presentation of a productive cough present for a minimum of three months in two consecutive years that cannot be attributed to other pulmonary or cardiac causes (Marx, Hockberger & Walls, 2014) (Viegi et al., 2007). Whereas emphysema is defined pathologically as as the irreversible destruction without obvious fibrosis of the lung alveoli (Marx, Hockberger & Walls, 2014) (Veigi et al., 2007).It is common for emphysema and chronic bronchitis to be diagnosed concurrently owing to the similarities between the diseases (Marx, Hockberger & Walls, 2014).
Unpleasant breathlessness that comes on suddenly or without expectation can be due to a serious underlying medical condition. Pneumonia can impact the very young and very old, asthma tends to affect young children, smokers are at greater risk of lung and heart disease and the elderly may develop heart failure. However, medical attention always needed by all these conditions as it can affect any age group and severe breathlessnes. There are short and long term causes of dyspnea. Sudden and unexpected breathlessness is most likely tend to be caused by one of the following health conditions. There is accumulating evidence that in many patients, dyspnea is multifactorial in causes, and that in most patients, there is no single, all-encompassing explanation for dyspnea.
The clinical manifestation one may see in patients with chronic bronchitis are chronic cough, weight loss, excessive sputum, and dyspnea. Chronic cough is from the body trying to expel the excessive mucus build up to return breathing back to normal. Dyspnea is from the thickening of the bronchial walls causing constriction, thereby altering the breathing pattern. This causes the body to use other surrounding muscles to help with breathing which can be exhausting. These patients ca...
-Shortness of breath=described as tightness of the chest. Some people have trouble breathing during exercise, others experience it after inhaling smoke, while others need to ingest a particular food-regardless of the circumstance, all people with asthma have trouble breathing.
Iron is a mineral that is found the in hemoglobin of the Red Blood Cells. It facilitates in the transport of oxygen all over the body. Without this mineral, oxygen cannot be carried to its full capacity. 1 out of 10 women and small children have iron deficiencies. Lacking iron causes lethargy and a weakened immune system. Children who do not have an adequate intake of iron put themselves at risk for intellectual developmental problems. However, an iron deficient person is not necessarily anemic. 7.8 million women are iron deficient, while only 3.3 million women are anemic (http://www.mayohealth.org/mayo/9704/iron_def.htm). When the deficiency becomes so severe that the circulating Red Blood Count and the minerals Ht, Hg, and Hem drop below normal, anemia occurs (See Figure 1). The hormone androgen causes men and women to have different normal values of the hemogram (http://www.medstudents.com.br/hemat/hemat4.htm). Low ferritin (iron storage molecule) and high TIBC (tota...
Respiratory assessment is a significant aspect of nursing practice. According to the National Institute for Health and Care Excellence, respiratory rate is the best indicator of an ill patient and it is the first observation that will demonstrate a problem or deterioration in condition (Philip, Richardson, & Cohen, 2013). When a respiratory assessment performed effectively on a patient, it can result in upholding patient’s comfort and independence in progress of symptom management. Studies have acknowledged that in spite of the importance of the respiratory rate (RR) it is documented rarely than the other vital signs in the hospital settings (Parkes, 2011). This essay will highlight the importance of respiratory assessment and discuss why nurses
...o those patients with chest pain, in order to maintain oxygen saturations as close to 100%, unknowingly realizing that the patient is being exposed to significant periods of hyperoxia (Moradkham & Sinoway, 2010 ). It has been suggested that this is due to poor monitoring skills by health professionals. (Moradkham & Sinoway, 2010 ). From reading this essay it is clear that there is a high demand and need of further clinical research into the effectiveness of oxygen in the client with chest pain. More research also has to be conducted in order for the health professionals to fully understand what oxygen does to the body. Through completing and implementing more updated and reviewed evidence and research on the effect of oxygen on the client with chest pain, a better practice can be put in place to ensure the patient is receiving the best care to save their life.
There are 2 types of breathing, costal and diaphragmatic breathing (Berman, 2015). Costal refers to the intercostal and accessory muscles while diaphragmatic refers to breathing using your diaphragm (Berman, 2015).It is important to understand the two different types of breathing because it is vital in the assessment of the patient. For example, if a patient is suing their accessory muscles to aid in breathing then we can safely assume that they are having breathing problems and use a focused assessment of their respiration. Assessing respiration is fairly straightforward. The patient’s respiration rate can be affected by anxiety so a useful to avoid this is to check pulse first and after you have finished that, while still holding their pulse point, check their respiration rate. Inconspicuous assessment avoids the patient changing their breathing because they know they are being assessed which patients can sometimes do subconsciously. Through textbooks and practical classes I have learned what to be aware of while assessing a patient’s respiratory rate. For example; their normal breathing pattern, if and how their health problems are affecting their breathing, any medications that could affect their respiratory rate and also the rate, depth, rhythm and quality of their breathing (Berman, 2015). The only problem I found while assessing respiration rate was I thought it seemed a bit invasive looking at the