Symptom Management of Dyspnea

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Symptom Management of Dyspnea Spring 2013 Dyspnea is a common but disabling symptom of many end-stage disease processes. It is also known as shortness of breath and observed as difficult or labored breathing with increased respiratory effort. Other terms used to describe dyspnea are “air hunger, not getting enough air, smothering” along with negative emotional reactions of “depression, anxious, frustrated, angry, and afraid” (Banzett et al., 2011). Dyspnea exerts negative impact on all domains of a patient's quality of life. It affects patients’ physical well-being, emotional well-being, social well-being, spiritual well-being and survival. The treatment should be the most disease-specific and palliative therapies, taking into account cost, availability, side effects, and patient wishes (Kuebler, Heidrich and Esper, 2007). Although medications will help to varying degrees, relief of dyspnea requires a comprehensive approach to its management. Treatment of the underlying condition or disease while concurrently addressing the symptom would be the main goal to alleviate the dyspnea, unless the patient requests comfort measures only. For the palliative care patient, the goal is excellent symptom control with the least possible sedation, allowing continued patient/family interaction (LeGrand and Walsh, 2010). Symptom management should provide the expected outcome of alleviating the symptom and altering the patient’s shortness of breath. The patient needs to be continuously monitored and reassessed to allow persistent symptom relief. If the interventions are not controlling the dyspnea, palliative care efforts should be intensified to maximize symptom control (Levy et al., 2012). Otherwise, sedation may be required for intractable dyspnea. Definition The 2012 American Thoracic Society consensus statement defines dyspnea as “a subjective experience of breathing

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