Why Can't You Breathe?!

What happens to our respiratory system during cardiac compromise (heart failure)?

As nurses on any unit it is important to monitor for signs and symptoms of cardiac compromise or heart failure. One of the most common sign and symptom is related to the respiratory system is shortness of breath. This should be monitored during routine nursing assessments by using auscultation and percussion. If patients are on a cardiac monitor (which they should be!) then it will be easy to monitor oxygen saturation in the blood and respiratory rate.

Take a listen...

 Nurses need to practice and become comfortable with the different lung sounds. In pulmonary edema secondary to heart failure, crackles can be heard throughout the lungs noting fluid in the pulmonary tissue. The Auscultation Assistant is a great resource for listening to all types of lung sounds!

What it looks like...

Normal Chest X-ray

Chest X-ray with severe Pulmonary Edema

Ahhh...it is making sense why our patients struggle to breathe! Throw a history of COPD, emphysema and/or asthma into the mix and our patients end up suffering even more. Make sure to get a thorough health history!

As nurses what can we do?

• Monitor, assess, monitor, assess and repeat!
• Administer medications such as Lasix or spironolactone 
• Patients will most likely need a foley catheter for strict measuring of intake and outputs! 
• Apply O2 via nasal cannula
• Incentive spirometer teaching
• Monitoring a diet low in sodium
• Activity as tolerated
• Staying on top of daily medications (especially cardiac medications and nebulizers)

Not only will your patients be able to breathe easy but so will you, knowing that you were able to take such great care of the patient!