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

Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease (COPD)Key Points■■■Incorporating exercise into daily routine has been known to improve:dyspnea, energy levels, muscle strength, activity levels, psychologicalwell-being.Individuals with COPD in advanced stages often have significantmuscle wasting as a result of physical de-conditioning.Individuals may experience bone loss as a result of corticosteroid use.There is clear evidence to support weight-bearing exercise in theelderly population to minimize the rate of bone loss.Education RecommendationRecommendation 6.0:Nurses working with individuals with dyspnea related to COPD will have the appropriateknowledge and skills to:■ Recognize the importance of individual’s self report of dyspnea■ Provide COPD patient education including:● Smoking cessation strategies● Pulmonary rehabilitation/exercise training● Secretion clearance strategies● Breathing retraining strategies● Energy conserving strategies● Relaxation techniques● Nutritional strategies● Role/rationale for oxygen therapy● Role/rationale for medications● Inhaler device techniques● Disease self-management and action plans● End-of-life issues■ Conduct appropriate referrals to physician and community resources. (Level of Evidence =IV)Discussion of Evidence:Individuals with COPD need regular supervision and support by healthcare professionals who areknowledgeable about COPD and its management. In order to provide the necessary support andeducation to individuals with COPD, nurses who are not specialists in COPD care require basic skills inthese identified areas. Education of healthcare providers about COPD best practices should address theknowledge, skill and attitudes necessary to implement the guideline recommendations.46