Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with ...

Nursing Best Practice GuidelineTable 2: Symptoms and Potential Nutrition SolutionsSymptomsDyspnea and fatigueDysphagia/Dental problemsOral thrush due to improperinhaled corticosteroid useDecreased appetite related toimpact of disease, depressionand/or social isolationDyspepsia/AerophagiaEarly satiety during mealsConstipation Consider easy meal preparation.Solutions Prepare meals utilizing simple recipes in bulk where single portions can be frozen. Stocking up on prepared foods may also be an alternate solution. Arrangements of home delivered meals may also be a possibility. Encourage resting before eating and cough techniques prior to meals(if necessary). Encourage the individuals to eat slowly and utilize pursed-lip breathing. Consider use of oxygen (if indicated) at meal times. Promote good dental hygiene. Assess denture fit and ensure adequate oral rinsing. Encourage high calorie, dense foods in a soft diet. Consider liquid nutritional supplementation. Assess oral cavity. Promote good dental hygiene. Ensure appropriate medical follow up. Ensure adequate rinsing of mouth post-inhaled corticosteroid.Consider liquid nutritional supplementation if individual is unable to eat. Assess nutritional intake and eating habits. Consider alternative eating environments (e.g., church-based or communitybasedvolunteer programs) Promote easy meal preparation alternatives (e.g., meals on wheels) Encourage individuals to eat slowly and chew food well. Smaller meals (5-6 smallmeals/day) are ideal for encouraging adequate nutritional intake. Avoid drinking while eating or carbonated beverages to prevent gas swallowing. Gas producing foods such as broccoli, cabbage, cauliflower and onions shouldbe avoided. Avoid drinking liquids one hour prior to meal time. Cold meals instead of hot meals, as hot meals create a sense of fullness. Consider liquid nutritional supplementation, to compensate for inadequatenutritional intake. Recommend high fibre foods and drinking of fluids. Promote mobility by encouraging exercise/activity as tolerated.RNAO Guideline Development Panel, 200533