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Measuring and monitoring vital signs
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
People with dyspnoea need to sit up, either in an armchair or on a bed well supported by pillows, to optimise ventilation. ‘Orthopnoea’ is the term used when people cannot breathe unless they are upright. Dyspnoea is frightening and psychological support is essential.
Spinal Cord Disease
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Ventilatory failure: Increased respiratory rate, orthopnea.Reduced vital capacity, which is worse on lying flat.Nocturnal hypoventilation causing daytime sleepiness/fatigue, frequent arousal and morning headaches, anorexia.Somnolence or mental status changes due to carbon dioxide retention/hypercapnia.
The patient with acute cardiovascular problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Orthopnoea – difficulty in breathing when lying flat – is also often a symptom of heart failure. This may be noticed at night (paroxysmal nocturnal orthopnoea). The patient may complain of being woken at night with extreme breathlessness, which may occur when the patient slips down the bed whilst sleeping. Sitting up or out of bed in a chair may help alleviate the symptoms.
Dyspnea in Parkinson’s disease: an approach to diagnosis and management
Published in Expert Review of Neurotherapeutics, 2020
Srimathy Vijayan, Bhajan Singh, Soumya Ghosh, Rick Stell, Frank L. Mastaglia
The circumstances under which dyspnea occurs is particularly noteworthy. While dyspnea occurring in the context of exercise or exertion is nonspecific and compatible with either a respiratory or cardiac etiology, a postural association may have more specific connotations. For example, orthopnea (recumbent breathlessness) is a common symptom of left ventricular failure and diaphragmatic weakness. Conversely, platypnea (dyspnea that improves when lying down and increases when sitting or standing) can occur with right-to-left shunts or ventilation-perfusion mismatching that may occur in pulmonary diseases or with orthostatic hypotension. The term ‘orthostatic dyspnea’ has been used to describe dyspnea when upright, resulting from ventilation-perfusion mismatch of the lung apices [28]. In the context of depression, anxiety, stress or during emotional states, dyspnea could be heightened or indeed represent a functional disorder. There may even be two or more causes for dyspnea in the same patient, and the clinician must remain open to all possibilities and investigate using a thorough and systematic approach.
A telehealth program benefits discharged patients with heart failure
Published in Acta Cardiologica, 2023
Guilan Cao, Cheng Fan, Yan Liu, Haixia Huang, Jing Li, Jing Liang, Baoming Tao, Jing Yuan
During the 12-week follow-up, patients in the intervention group were monitored and managed through a 15-minute phone call every 2 weeks. The management contents included evaluating patients’ health status, identifying signs or symptoms of decompensation or exacerbated cardiac function, recording patients’ adherence and tolerance to therapy, providing recommendations for medication or treatment, reminding patients of necessary examinations or doctor appointments and reinforcing the predischarge education including instructions on how to quickly self-evaluate the cardiac function, such as: (a) the occurrence of dyspnoea; (b) the severity of edoema; (c) whether being oppressed during sleep; (d) the severity of orthopnea; (e) the severity of dizziness or confusion. The detailed contents and the standardised checklist of the telehealth interview for telehealth group are showed in Supplemental Table 1. For control group, patients received the same education as the telehealth group at discharge, while no further management or education were provided to them. During the last phone call, all the patients’ information in both groups including patients’ status, disease condition, history of readmission, medication adherence, self-care behaviours and mental health status were collected. The Self-Rating Depression Scale (SDS) [18] was used to evaluate patients’ mental health. The scores range from 25–100 classified as normal range (25–49 point), mildly or moderately depressed (50–69 point) and severely depressed (70 and above). This program was done by 18 nurses and 6 cardiologists in the Heart Failure Centre, Wuhan Union Hospital. All the staffs were qualified with working experience in this centre for more than 2 years.
Care of traditional patients in the campaign against COVID-19: casualties of friendly fire
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
As news of COVID-19 global spread saturated the medical and lay media, an independently living 88-year-old woman, Ms. F, presented to our institution with sudden onset shortness of breath. In recent days, she had experienced intermittent chest pain and had developed abdominal swelling and orthopnea. On admission, she was a slight woman, alert, but hypoxic. A week prior she had noted vague upper respiratory symptoms, and while her chest film suggested pulmonary edema, an infectious process could not be excluded.