a patient having an acute asthma attack will report dyspnea.

by Rico DuBuque 8 min read

The Interpretation of Dyspnea in the Patient with Asthma

2 hours ago When acutely ill, both the API and all spirometric measures (PEFR; FEV1; IC) correlated with dyspnea. Multiple linear regression showed that measures of the API, the peak expiratory flow rate, and female sex taken together accounted for 41% of dyspnea in acute asthma. After treatment, the API again predicted dyspnea while spirometric data did not. >> Go To The Portal


Physicians have noted dyspnea in severely ill asthmatic patients to be associated with fright or panic; in more stable patients dyspnea may reflect characteristics including lung function, personality and behavioral traits.

Full Answer

What happens to a patient who has been experiencing an asthma attack?

A patient who has been experiencing an asthma attack develops bradycardia and a decrease in wheezing. Which action should the nurse take first? a. Encourage the patient to cough and deep breathe.

When a patient with asthma is admitted to the emergency department?

A patient who is experiencing an acute asthma attack is admitted to the emergency department. Which assessment should the nurse complete first? Listen to the patients breath sounds. Assessment of the patients breath sounds will help determine how effectively the patient is ventilating and whether rapid intubation may be necessary.

What does the nurse review during an acute asthma attack?

The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication should the nurse administer first? a. Albuterol (Ventolin HFA) 2.5 mg per nebulizer

Is dyspnea a primary symptom of asthma?

Purpose of review: Dyspnea--the perception of respiratory discomfort--is a primary symptom of asthma. This review examines possible ways to link mechanisms, measurement and treatment that will increase our understanding of this condition.

Is dyspnea a symptom of asthma?

Dyspnea is a symptom of asthma. Environmental pollutants such as chemicals, fumes, dust, and smoke can make it more difficult for people with dyspnea to breathe. People with asthma may find that exposure to allergens such as pollen or mold may trigger episodes of dyspnea.

What is acute dyspnea?

Acute dyspnea—breathing discomfort occurring within hours to days—is a common cause of emergency department visits and hospital admissions and may be a sign of cardiorespiratory decompensation among hospitalized patients.

What causes acute dyspnea?

Acute dyspnea is most likely caused by acute myocardial ischemia, heart failure, cardiac tamponade, bronchospasm, pulmonary embolism, pneumothorax, pulmonary infection in the form of bronchitis or pneumonia, or upper airway obstruction by aspiration or anaphylaxis.

What are the assessment of dyspnea?

Initial Assessment of Patients with Dyspnea Assess airway patency and listen to the lungs. Observe breathing pattern, including use of accessory muscles. Monitor cardiac rhythm. Measure vital signs and pulse oximetry.

What are the symptoms of dyspnea?

Shortness of breath — known medically as dyspnea — is often described as an intense tightening in the chest, air hunger, difficulty breathing, breathlessness or a feeling of suffocation. Very strenuous exercise, extreme temperatures, obesity and higher altitude all can cause shortness of breath in a healthy person.

What can you do for acute dyspnea?

Dyspnea is treated by addressing the underlying disease or condition. For example, if dyspnea is caused by pleural effusion, draining fluid from inside the chest can reduce shortness of breath. Depending upon the cause, dyspnea can sometimes be treated with medication or by surgical intervention.

Is dyspnea chronic or acute?

The experience derives from interactions among multiple physiological, psychological, social, and environmental factors, and may induce secondary physiological and behavioral responses." Dyspnea is considered acute when it develops over hours to days and chronic when it occurs for more than four to eight weeks.

Does dyspnea increase respiratory rate?

The rise in respiratory rate increases the work of breathing, and the obstructed outflow of air in COPD leads to worsening hyperinflation and heightened stimulation of mechanoreceptors. This results in more dyspnea, which may make the patient breath faster and worsen the hyperinflation still more.

Why does dyspnea occur in asthma?

Dyspnea in acute asthma reflects both uncoupling of inspiratory effort from inspiratory flow (airway narrowing) and hyperinflation. Both uncoupling and hyperinflation are promptly relieved by treatment. Subsequently in stable subjects, lung function is no longer a major determinant of dyspnea.

What is the difference between dyspnea and dyspnoea?

Dyspnoea (also is known as dyspnea, shortness of breath or breathlessness). "Is a subjective sensation which probably develops as a result of the integration of signals from the central nervous system and some peripheral receptors."

How do you assess dyspnea in nursing?

Nurses used several signs to infer dyspnea: tachypnea, difficulty speaking, accessory muscle use, nasal flaring, and restless movements were behaviors used frequently to assess for distress; heart rate and fearful facial expression were signs used less often (Additional file 21: Figure S18).

How many English speaking asthmatic patients were studied twice?

We studied 32 English-speaking acutely ill asthmatic patients twice: once immediately upon their arrival in the emergency room and again after stabilization. Subjects older than 50 years or younger than 18 were excluded as were pregnant women and those with coexisting chronic heart or lung disease.

What are the symptoms of bronchoconstriction?

Many reported difficulty working, speaking, and concentrating. Some described sweatiness and shaking. Two reported extreme symptoms such as the need to urinate or defecate. It is likely that an occasional patient presents with both severe bronchoconstriction and panic, too agitated to participate in a study.

Is dyspnea a symptom of asthma?

Dyspnea is a cardinal symptom of asthma. The notion that fear or panic may contribute to the sensation of dyspnea accompanying acute bronchospasm has been recognized by clinicians and is discussed in the psychiatric literature [ 1.

Is SPTZ a diagnostic tool?

The observation that the SPTZ correlates with dyspnea in the treated but not the acutely ill asthmatic patient is of interest. The SPTZ is not a definitive diagnostic tool. It is a self-assessment screening tool that identifies patients who believe they qualify for the diagnosis of panic.

Is hyperinflation a determinant of dyspnea?

Both uncoupling and hyperinflation are promptly relieved by treatment. Subsequently in stable subjects, lung function is no longer a major determinant of dyspnea. Anxiety, as measured by the API, is a major determinant of dyspnea in the acutely ill subject. As such it is likely to be a component of acute panic.

Does dyspnea correlate with lung function?

Lung function and dyspnea did not correlate. Both the API and the binary assessment for the clinical diagnosis of panic correlated with dyspnea in the stable subjects. By contrast, correlation between dyspnea and either the SSAS or the BMI did not reach statistical significance.

Why do you need to check the bathroom before exiting an AED?

A designated individual must check the entire facility, including bathrooms, before exiting, making sure to close all doors when leaving to try to contain a fire or other disaster. An AED may save the life of a victim in cardiac arrest.

What to do if a fire is suspected?

If a fire is suspected, immediately disconnect oxygen supplies or turn off oxygen tanks to prevent an explosion. 4. Make sure smoke alarms are located throughout the facility, checked periodically, and replaced as needed. 5.

Why is it important for a nurse to assess the bubble through humidifier?

This adds to the comfort of the patient. The nurse assesses the patient to make sure the nasal cannula is worn correctly for optimal effect. The cannula can become easily dislodged.

What does it mean when your expiratory volume is 80?

If the forced expiratory volume in one second is more than or equal to 80, it indicates that patient B has mild asthma.

Can you use a thoracoscope for COPD?

Not use thoracoscope: Airway bypass is a bronchoscopic procedure that helps to treat COPD by creating extra anatomic openings between the diseased lung and bronchi. A 71-year-old patient with chronic obstructive pulmonary disorder (COPD) has a 40-pack a year history of cigarette smoking.

How long before pulmonary function test for asthma?

When preparing a patient with possible asthma for pulmonary function testing, the nurse will teach the patient to. a. avoid eating or drinking for 4 hours before the forced expiratory volume in 1 second (FEV1)/forced expiratory volume (FEV) test. b. take oral corticosteroids at least 2 hours before the examination.

What is asthma admission?

1. A patient with a history of asthma is admitted to the hospital in acute respiratory distress. During assessment of the patient, the nurse would notify the health care provider immediately about

What inhaler is used for asthma?

8. A patient who has mild persistent asthma uses an albuterol (Proventil) inhaler for chest tightness and wheezing has a new prescription for cromolyn (Intal). To increase the patient's management and control of the asthma, the nurse should teach the patient to.

What does fatigue and hypoxia indicate?

Rationale: Although all of the assessment data indicate the need for rapid intervention, the fatigue and hypoxia indicate that the patient is no longer able to maintain an adequate respiratory effort and needs mechanical ventilation.

Abstract

Introduction

  • Dyspnea is a cardinal symptom of asthma. The notion that fear or panic may contribute to the sensation of dyspnea accompanying acute bronchospasm has been recognized by clinicians and is discussed in the psychiatric literature [1]. Similarly, physicians caring for outpatient asthmatics have long recognized that both personality traits and psycholog...
See more on hindawi.com

Materials and Methods

  • We studied 32 English-speaking acutely ill asthmatic patients twice: once immediately upon their arrival in the emergency room and again after stabilization. Subjects older than 50 years or younger than 18 were excluded as were pregnant women and those with coexisting chronic heart or lung disease. Spirometry was first performed upon arrival at the emergency service before ad…
See more on hindawi.com

Results and Discussion

  • We studied 18 M and 14 F subjects. Their mean (SD) age was 38 ± 7; their weight (BMI) was 30 ± 9 kg/m2. Their median initial Borg score was 5.0 (0.5; 8.0). Initial lung function data showing severe airway obstruction appear in Table 1. Lung functions and their correlations with dyspnea during acute illness appear in Table 1 also. Measures of all lung functions as well as panic (API) …
See more on hindawi.com

Conclusion

  • We conclude that the self-report of dyspnea and spirometry obtained simultaneously provide complementary information for the routine assessment of stable asthmatic patients.
See more on hindawi.com

Acknowledgments

  • The author thanks Dr. Soyeon Kim for her assistance with the statistical analysis and Dr. Norma MT Braun and Dr. Monroe Karetzky for critical review of the final paper. Dr. Neil Cherniack played an integral role in the development of this project but passed away before its completion.
See more on hindawi.com