Managing Dyspnoea Flashcards
1
Q
What are the objective clues of dyspnoea?
A
- Mouth breathing
- Using accessory muscles
- Big breaths
- Body positioning
- Pursed lips
- Increased respiratory rate
- Red/blue face
- Upper chest breathing
- Inspiration:expiration
2
Q
What are the strategies for managing dyspnoea?
A
- Intermittent exercise with clear goals
- Self-pacing (encourage patient to slow down)
- Allow adequate rest for recovery
- Support upper limbs
- Encourage lean-forward position
- Encourage purse-lipped breathing
- Encourage breathing control
3
Q
Why does leaning forward reduce dyspnoea?
A
Abdominals push the diaphragm back up into the dome shape, allowing it to work better as a lever for breathing
4
Q
What is the physiological rationale for purse lipped breathing?
A
Creates a small positive pressure which may help splint open airways during expiration
5
Q
What is the physiological rationale for breathing control?
A
- Improves mechanical efficiency of breathing
- Reduce unnecessary muscle activity, particularly in upper chest & shoulders
- Reduces energy cost of breathing
6
Q
What does breathing control generally consist of?
A
- Relaxation of upper limbs/shoulders
- Normal tidal breathing encouraged (not deep breathing)
- Encourage patient to focus on expiration
- Make expiration > inspiration by asking the patient to breath out progressively longer over a few minutes
- Breath with the patient
7
Q
What is used to measure dyspnoea?
A
Modified Borg dyspnoea scale