Dyspnea management in patients with pneumonia and coronary artery disease: A case study

Abstract

Background: Cardiovascular disease, particularly Coronary Artery Disease (CAD), is strongly linked to pneumonia. Patients suffering from both pneumonia and CAD frequently experience dyspnea as a symptom. Dyspnea, caused by both conditions, can significantly impact the patient's quality of life. Consequently, it is crucial to address and manage dyspnea in individuals with pneumonia and CAD.

Purpose: To provide a thorough overview of managing dyspnea in patients with pneumonia and CAD in public hospitals in West Java, Indonesia.

Method: Employing a case study methodology using a nursing care approach, encompassing nursing assessment, data analysis, diagnosis, intervention, implementation, evaluation, and documentation. The assessment indicated that the patient experienced shortness of breath, with a blood pressure of 145/86 mmHg, a respiratory rate of 24 breaths per minute, a pulse rate of 95 beats per minute, and an oxygen saturation level of 88%. The patient received 5 liters per minute of oxygen via a nasal cannula, and their body temperature measured 36.4ºC.

Results: In this case study, dyspnea management involved positioning the patient, administering oxygen therapy in stages, and providing pharmacological treatments, including diuretics and antibiotics. Additional therapies included respiratory muscle training and effective cough exercises. These interventions successfully reduced the patient's respiratory rate to 18 breaths per minute and increased their oxygen saturation to 97% with a nasal cannula. Additionally, the patient's Medical Research Council (MRC) dyspnea scale score decreased to 1 out of 5.

Conclusion: Nursing care management that includes positioning the patient in a semi-Fowler's position while resting and a Fowler's position when awake, administering oxygen therapy in stages, providing pharmacological treatments such as diuretics and antibiotics, and conducting respiratory muscle training, can lower the breathing rate and alleviate symptoms of shortness of breath in patients with pneumonia and coronary artery disease.