Dyspnea

Definition

Dyspnea is the subjective experience of breathing discomfort, a sensation of breathlessness, suffocation, or air hunger. It is both a symptom and a cardinal cue for numerous conditions.

Common Causes

• Cardiac: CHF, acute MI, pulmonary edema, cardiac tamponade
• Pulmonary: asthma, COPD, pneumonia, pulmonary embolism, pneumothorax
• Systemic: anemia, anxiety, metabolic acidosis, sepsis

Assessment

Sudden-onset dyspnea is an emergency. Assess airway, breathing, circulation, work of breathing, oxygen saturation, vital signs, breath sounds, and mental status. Use a 0 to 10 dyspnea scale. Orthopnea (SOB lying flat) and paroxysmal nocturnal dyspnea (PND) suggest CHF.

Nursing Interventions

Position high-Fowler's or tripod, administer oxygen (titrate for COPD to 88 to 92%), obtain ABG and chest x-ray, reassure the patient, administer bronchodilators, diuretics, or anticoagulants as indicated. Acute dyspnea with pleuritic pain + tachycardia = suspect PE.

NCLEX Relevance

High-priority cue for life-threatening conditions. ABCs always first.