Hоw will you care a patient with dyspoea
Answers
Explanation:
Observing patients provides information about their breathing. This will include:
Recording and observing respirations (Boxes 1, 2 and 3);
Observing the patient’s colour - cynaosis is a blue discoloration of the skin and mucous membranes and is most noticeable around the lips, earlobes, mouth and fingers. It can indicate a severe lack of oxygen. In dark-skinned patients, signs of poor perfusion or cyanosis may be detected if the area around the lips or nail beds appears dusky in colour;
Observing the patient’s position: sitting upright, with shoulders hunched up, suggests that the patient is working hard to breathe.
A visual analogue scale can be a useful tool to assess patients’ experience of their dyspnoea and when any intervention has been beneficial.
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Answer:
Observation of the patient
Observing patients provides information about their breathing. This will include:
Recording and observing respirations (Boxes 1, 2 and 3);
Observing the patient’s colour - cynaosis is a blue discoloration of the skin and mucous membranes and is most noticeable around the lips, earlobes, mouth and fingers. It can indicate a severe lack of oxygen. In dark-skinned patients, signs of poor perfusion or cyanosis may be detected if the area around the lips or nail beds appears dusky in colour;
Observing the patient’s position: sitting upright, with shoulders hunched up, suggests that the patient is working hard to breathe.
A visual analogue scale can be a useful tool to assess patients’ experience of their dyspnoea and when any intervention has been beneficial.
Pysiological care.
Dyspnoea can be very frightening for patients and may result in increased anxiety, causing them to become more breathless. Nursing intervention can break this cycle. Allowing time with breathless patients, talking calmly to them and instructing them to breathe slowly, and breathing with them, can be highly effective.
For some patients, a more tactile approach, with gentle rubbing of the back and stroking of an arm, can sometimes help to relax them, thus reducing the respiratory effort. Some people, however, do not find this approach helpful, therefore it is important to discuss tactile approaches with them.
Ensuring the room is well ventilated can be of benefit and some patients find the use of a fan blowing air on to their face provides some relief.
Distraction can help some patients take their mind off their dyspnoea, and many will report that they are less aware of their symptoms when they are occupied with something else.
Communication
Patients with dyspnoea may be too breathless to speak more than one or two words. Using closed questions, which can be answered with a nod or a shake of the head can allow them to communicate. This requires time and patience and it is essential that the nurse does not make assumptions on behalf of the patient. Alternatively, enabling patients to write on paper or to use flash cards can help them to communicate effectively.
Some patients will require oxygen therapy with an oxygen mask, which is a further barrier to communication. Nasal cannulae are a useful alternative, as they allow the nurse to observe lip movements and lip read.
Sputum clearance
sputum clearance
Specific breathing exercises can be highly beneficial for patients with chronic dyspnoea. Controlled breathing techniques should be taught to patients while they are not breathless, and they should be encouraged to practise them regularly. When they become breathless, they should be able to use these techniques to control their respiratory rate and reduce their discomfort.
Removing sputum can reduce dyspnoea, and patients should be encouraged to expectorate and dispose of sputum in a tissue or sputum pot. In hospitals, sputum pots should be changed at least daily to reduce the risk of cross-infection
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