Nursing Assignment 2022

Running Head: NURSING ASSINGMENT 0
DYSpnea : labored breathing

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The patient has been suffering from the recent onset of dyspnea who has a history of
Chronic Obstructive Pulmonary Disease (COPD), the man is in his sixties and had started taking
treatment for the disease. The medication includes antibiotics, anticoagulants, bronchodilators,
corticosteroids, decongestants, Beta-adrenergic receptor agonists and diuretics. The patient has
been recently suffering from the side-effects of the medication. The antibiotics provided by the
doctor had affected the liver because of which he is experiencing severe symptoms of diarrhea
such as vomiting, indigestion and loss of appetite. The diuretic is causing severe skin rashes and
problem of increased cholesterol. The anti-anxiety pills provided by doctor to control the
aftermath anxiety has caused the increased pulse rate in the patient ( Dresden, 2018). There are
some mild symptoms which are caused with the high dosage of decongestants to control regular
coughs such as mild anxiety and dizziness. There are many side-effects a person is going through
after he started treatment of dyspnea such side effects are causing inconvenience in his regular
life. The side-effects are stopping the full recovery of the patient. The following essay will be
doing the literature review on evaluating the evidence- based holistic interventions for the patient
side-effects of selected treatment or symptom and will also be discussing the factors responsible
for planning the educational session to the patient about the side effect or symptom of the
disease. The objectives of the essay is to research about the pharmacological and non-
pharmacological interventions to control the symptoms and side-effects of the disease in a
patient and to discuss the important factors responsible for conducting the informative
educational session of the patient.
The symptoms of the patient can be intervened by using various pharmacological and
non-pharmacological therapies. According to the author of the article “Recent Advances in the
Management of Breathlessness” by Katrina breaden , symptoms and side- effects of dyspnea
which include breathlessness can be cured through various non-pharmacological therapies which
include listening to the patient and to avoid telling them to calm down and various kind of
relaxation training can be of help but such should be introduced at the introductory stage of the
disease as in later stages high fatigue will not make it possible for them. Acupuncture can be
essential in treating the symptoms as due to the acupuncture lung function improves thus helping
in the process of breathing. There are other controlled breathing exercises and techniques which
includes pursed lip breathing, upright leaning forward position, chest wall vibration, neuro-
electrical muscle stimulation can control the symptoms to large extent ( Breaden, 2011). In a

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journal article by M Woolard who discusses the pharmacological techniques which include the
consumption of opioids which results in the slow release of morphine is beneficial for reducing
the ventilatory demands of a patient (Woollard, 2018). Anxiolytics can be helpful in controlling
the anxiety but the tolerance level of the drug depends on the patient if a patient had a liver
failure then taking anxiolytics is not recommended. One of the major symptoms of dyspnea
includes regular cough, According to the authors of journal article by Bausewein and Simon, the
cough can be cured by drinking plenty of warm fluids and by breathing moist air through
humidifier or steamy shower (Bausewein & Simon, 2013). It can be cured by doing the gargle of
warm salt water and by taking a well-balanced diet if balanced diet is not available then daily
dose of multi-vitamins. In a Journal Article by Pattee and W G thompson cautions to avoid dairy
products as phlegm can be thicken by its consumption and alcohol should also be avoided at any
cost as it could damage the immune system of the body (Pattee & W, 2005). Diarrhea is the side-
effect caused by having high dose of antibiotics due to dyspnea so, in a Journal article by
Marinescu and Rădoi discusses by non- pharmacological ways of treating the diarrhea can be
having the light diet of fruits which have high fibers and sticking one’s diet more to liquids and
also completely avoiding the drinks which include high caffeine or sugar which can exacerbate
the situation of the diarrhea (Marinescu & Rădoi, 2018). One should also avoid consumption of
diary products as they may cause lactose intolerance in an individual. The authors of journal
article “ Managing Acute diarrhea” by Amerine & Keirsey instructs to try BRAT diet which
means bananas, rice, applesauce and toast as it is considered the light diet (Amerine & Keirsey,
2019). It is also advisable to eliminate the food in the diet which is felt that the cause of diarrhea
is a certain food. There are other pharmacological ways of curing it by trying over the counter
medicines which do not require the prescription of the doctor which includes Imodium and
pepto-bismol or kaopectate as they can be used on seldom occasions.
The dyspnea can cause bloating or swollen feet. In an blog by Medline Plus, the non-
pharmacological ways of getting relief or curing is following a low salt diet as it may lessen
swelling and to get relief by it is wearing lose clothing’s or support stockings which are available
at nearby drug stores (Sinha, Edmonds, Newton‐Bishop, Gore, Larkin, & Fearfield, 2012).
Another way is doing a certain type of leg exercise to cure the swelling on legs. Sometimes, the
patient suffers from the anxiety due to the disease so doctor recommends the patient with anti-
anxiety pills to control the anxiety, the side effect causes the increased pulse rate which can be

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cured through non-pharmacological ways. In a journal article by Pal and Radavelli-Bagatini, they
discusses that the pulse rate of the patient can be controlled through non-pharmacological ways
which includes doing deep guided breathing, performing stretching exercise such as yoga and
doing exercise daily in morning, other tips which can be followed are keeping the body hydrated
with fluids which causes less pressure on heart to control the blood flow in the body (Pal &
Radavelli-Bagatini, 2013).
One should avoid taking stimulants such as caffeine and nicotine as it causes dehydration
thus increasing workload of heart. The authors Fernández-Solá and Junqué claim that the cause
of dehydration in the body is high-intake of alcohol as it is toxin and must be avoided at all cost.
Eating healthy balanced diet rich in omega-3 fatty acids, phenols and tannic, vitamin A and C,
dietary fiber is responsible for lowering the blood pressure (Fernández-Solá & Junqué, 2010).
Other ways the person can achieve the targeted heart rate according to the age is by getting
enough sleep, maintaining a healthy body weight as excessive weight results in unhealthy bodily
functions, depressed mind is also the cause for increased heart rate so which can be cured by
seeking the psychological services and counseling. In the journal article by authors Eppley and
Abrams relaxation techniques can also be practiced such as doing visualization and meditation
which helps in reducing stress and even the getting involved in outdoor activities could make a
person happier thus reducing stress (Eppley & Abrams, 2010). In a journal article authors Jatoi,
Rowland and Sloan suggest some of the pharmacological ways of treating skin rashes are using
corticosteroids in the form of foams, lotions, ointments and creams. Using non-steroidal
ointment also help in the treatment of the skin rashes (Jatoi, Rowland, Sloan, & A., 2008).
In a Journal article by Sinha, Edmonds, Newton‐Bishop, Gore, Larkin, and Fearfield, the
skin rashes can be cured by using anti-itch cream which contains one percent hydrocortisone thus
making it to be effective there are other antihistamines like diphenhydramine and hydroxyzine to
control the itching, various moisturizing lotions can be of importance in treating the problem of
rashes (Sinha, Edmonds, Newton‐Bishop, Gore, Larkin, & Fearfield, 2012). Some of the
medicines consumed for the treatment of dyspnea cause the problem of increased cholesterol in a
patient. In a Journal report by author mahmood writes about the foods which can lower the
cholesterol in a person which include almond and nuts as consumption of almonds improves the
blood lipid profiles in a patient by lowering- down TC levels, LDL levels and the ratio of LDL to

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HDL (Mahmood, 2015). In an article published in American Heart association discusses the
importance of consuming Avocado as it is very helpful in controlling the cholesterol in an
individual as it leads to significant reduction in TG, LDL and the total cholesterol by 28.29
percent (American Heart Association News, 2015). The authors of Journal article Mohanty,
Sudheesan, Sankar, Das, & Sharma suggest Consuming fish, as it is rich in omega 3 fatty acids
thus helpful in controlling the cholesterol level in a patient and eating fruits are also the best way
to cure the problem of cholesterol due to the presence of high presence of antioxidants
components (Mohanty, Sudheesan, Sankar, Das, & Sharma, 2011).
Educational sessions are a must as it educates the patient regarding the symptoms and the
side-effects which arise as result of taking medicines for the treatment of the diseases as it helps
the patient to cope with the disease intelligently. Before planning the educational session of the
patient, it is important to keep in mind various factors such as physiological needs of the patient,
working environment and psychological factors (Advisory Board, 2017). The physiological
needs of the patient include that they are physically strong to sit for long hours to get educated
with the symptoms and side-effects of the disease and they are not experiencing any kind of
fatigue or exhaustion when the session is being conducted for them. As my patient is in his
sixties, looking at the age of the patient, conducting the session for long hours is not possible, it
is better to conduct session in small chunks like for an hour to avoid any kind of fatigue.
Another important need is psychological needs means that the patient is mentally strong
to take on the hard words related to the diseases; he is suffering from. Any kind of information
related to the side-effects or the symptoms of the disease conveyed to the patient will not be the
cause of anxiety thus worsening the condition of the patient. It is important to ensure that the
patient is sound- minded to take in the educational session on the disease. It is also important to
ensure that any information dispatched to the patient is taken positively like in this case, the
patient is in his mature age to digest the clear words regarding the disease symptoms and side
effects. In other words, he is strong enough to accept the information delivered to him. As said
by author wollard, there are other social-cultural factors which should be taken in account which
include lifestyle, values, income-level, education and language (Woollard, 2018). Income-level
plays significant role as it is important to know the patient’s income level to know what type of
treatment can be affordable to him as discussing about the expensive treatment could create

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hopelessness in a patient due to the patient’s position of unaffordability. It is essential to take in
account the patient’s educational background whether the individual will be able to understand
the messages conveyed to him, whether the person is able to catch up with the terminologies
used in educational session. Another factor is language, it is important to care that the patient can
understand the language in which the session is being conducted so if the need arises to change
the medium of communication so it can be changed to video session also. Lifestyle also plays the
important factor, if a person follows the lifestyle where he cannot afford a healthy diet then
advising to change the diet would not be feasible suppose any athlete suffers from the disease,
advising him to completely say no to the exercise is not feasible. The educationist must take care
of the person’s religion values and sentiments and accordingly conduct the session for the
patient, As my patient is a retired employee in his sixties so he is unable to afford expensive
treatment looking at his income level, as he was the retired employee from a corporate, it would
be tough for him to grasp the tough medical words and it would be better to use a vernacular
language with simple words to make him understand the session.
The working environment also affects the educational session of the patient as the
availability of physical, human, financial resources is important. Physical resources plays an
essential part in patient’s education as rightly discussed in the journal article by shattell which
include good quality projectors, camera, audio system and other important equipment to bring
the session into reality (Shattell, 2014). Financial resources mean enough money required to
organize the good informative educational session for patients as money is needed for paying
fees to the trainers who are there to impart knowledge to the patients and organizing video
sessions. The authors Farahani, Mohammadi, Ahmadi and Mohammadi of journal article suggest
the importance of availability of right nurses who have the skills and the knowledge to educate
the patients about the side-effects and symptoms of the disease they have the capability to clear
the doubts of the patients and to manage any kind of contingency which arises effectively in the
educational program ( Farahani, Mohammadi, Ahmadi, & Mohammadi, 2013).
When organizing the session, it is essential to decide upon the goals as they provide the
specific target to be accomplished. A good target helps in organizing things effectively. The
goals should be divided into short and long term, as this bifurcation helps easy distribution of
mile stones to be achieved. the short-term goals for the session for my patient could be creating

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awareness about what the disease is all about and its side-effects and symptoms, for example
creating awareness about dyspnea and its symptoms so that they are able to manage themselves
mentally and physically. The long-term goals for an educational session include helping them
adjust their lifestyle according to the disease they are suffering from. Feudtner advised to tell
patients during educational session the methods to deal with side-effects that come along with
high -dosage of medicines for example when a person takes antibiotics their digestion system
gets affected so in a session the nurse can guide them to take a diet involving BRAT and to take
more fluids ( Feudtner, 2011). The long-term goals are all concerned in bringing in the positivity
in the face of disease. In the case of my patient as he was previously suffering from the problems
of asthma or COPD so in-depth explanation of the disease is not required but the short term goals
could be to briefly explain him about the disease and to make him feel comfortable with it and
the long term goals could be to infuse in him the positive mental outlook regarding the disease
by helping him effectively adjusting with the side-effects and symptoms.
In long term goals the nurse teaches them the various strategies to prevent deterioration,
exacerbation or recurrence of the side effect or symptom. Those strategies could be to do
breathing exercise or yoga as it helps in managing the breathlessness symptoms by increasing the
lungs capacity, the exercise is also helpful in reducing anxiety in the which comes with the
disease.it is also important to start taking diet rich in omega 3 fatty acids which is helpful in
reducing cholesterol and also taking a balanced diet rich in vitamin A and C which is helpful in
controlling the pulse rate. As a person will be high on antibiotics, which may affect the person’s
digestion process so it is important for the person to get on having light foods and more liquids
as it will be helpful in further deterioration of the symptoms and managing the overall health
during the medication phase of the person ( Stephens, 2019). The diuretics medicine which is the
part of the treatment causes the problem of cholesterol which can be controlled by taking right
kind of food such as avocado, fish and almonds. One should keep their active part of their life
alive as it helps in managing the person’s physical, emotional and mental health there by
reducing the stress which arises in the process. One should take care of any signs and symptoms
that may arise as a potential medical emergency which includes labored or shallow breathing,
heart palpations, excessive coughing, tightness in chest and suffocation. On the onset of any such
symptoms or side-effects of medicine which include extreme diarrhea, excessive skin rashes, one

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should visit the doctor for controlling the symptoms as any kind of delay could be detrimental to
person’s health ( Mueller, 2018).
When imparting education to the patient, it is important to know which strategy of
delivering the knowledge to the patient suits, as some prefer education through a video or some
want the doctor guiding them personally. Initially it is important to know the background of the
patient and their needs. Another important factor responsible is starting a session at right time as
the patients who got to know the diagnosis of the disease will take time to digest the news when
they are ready for the new learning and it is essential to fix the session at a time when they do not
get disturbed by the lunch time and visitors. It is being advised by the journal article authors
Warsi, Wang, LaValley, Avorn, and Solomon that to recognize how much the patient already
knows about the disease whether the patient has any prior knowledge related to it or not, if the
person is aware about the dyspnea and its symptoms then it is better to start the session with its
treatment rather than wasting time in explaining them what the disease is all about (Warsi,
Wang, LaValley, Avorn, & Solomon, 2014). Before starting the session, the nurse should be
aware of the patient’s education level whether he can understand the complex medical
terminologies or not. If he cannot understand the tough medical vocabulary used, it is better to
use simpler terms so that the understanding becomes clearer. It is essential to organize the
teaching according to the patient’s physical abilities as my patient is in his sixties so it is
important to use more of pictures and good quality audio system to make him understand the
disease and its implications. In a session various recommendation are given, it is important to
give recommendation according to the person’s income level, as my patient is in his sixties and
has less capability of earning money so it is better to recommend him those treatments which are
less expensive. The most important thing according to author Brixey is to deliver the information
in small chunks then in big chunks as it becomes easier to digest (Brixey, 2014).
After every education session, it is important to evaluate its outcomes. The most
important criteria to evaluate the educational session is the improvement in the patient’s health
and his mental outlook towards the disease. If the patient is acting positively with the treatment
and has become receptive to things recommended to him which is considered the positive sign.
Proper following of the instructions given to him in the session, if the patient is actively
following the instructions given to him by the nurse then the educational session conducted is

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considered successful. The inquisitiveness of the patient and he is asking more in-depth
questions related to the disease and its symptoms and is ready to take the recommendations
suggested to him by doctors and nurses. According to the journal article authors Sobieraj &
McCaffrey, regularity is another important criterion to judge, if the patient is regular with the
check-ups and treatments which shows the session had impacted him positively ( Sobieraj &
McCaffrey, 2009). In any instance at the hospital, if the patient is seen spreading good word of
mouth about the hospital and the treatment it provides to the patient to the outsiders then the
educational session is considered successful.
The essay dealt with the effective management of the dyspnea in a patient who is in his
sixties and suffering from the disease which is signified by shortness of breath and causes
troubles in day to day workings of life. There is no. of symptoms which come with the disease
which are treated by medicines provided by the doctor but with medicines come with its side
effects so it becomes essential to manage them. There are number of non- pharmacological ways
which can be followed such as doing breathing exercise which is responsible for increasing the
lungs capacity, following the balanced diet which involves high intake of fluids can also curb the
problem of diarrhea. Taking a BRAT diet is one of the ways of controlling diarrhea. These
pharmacological and non- pharmacological ways are of no use until conveyed to patient
intelligently. For that an educational session is required and to make educational session
successful, it is important to take all the factors related to patient into account such as patient’s
educational background, income level and lifestyle and accordingly the session to be designed.
The educational session should be conducted in time and at a proper location as these factors
affect the learning focus of the patient. After the session gets over, it is important to evaluate its
outcome so that better session can be presented next time. The evaluation can be done by taking
patient’s feedback if there are gaps between the standard expectations and the real feedback of
the patient then those gaps can be filled by appropriate interventions as it the good educational
session of the disease is required for the patient’s first recovery.

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