Stresses of breathlessness

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Stress of BreathlessnessStress of Breathlessness

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Home Health

Presented byGerri Virgil, M.S.N., R.N. Case Manager

Home Health

Presented byGerri Virgil, M.S.N., R.N. Case Manager

Managing TheStress Of Breathlessness

Managing TheStress Of Breathlessness

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• Describe physiologic changes and physical signs, symptoms of stress

• Identify use of non-pharmacologic modalities used to treat breathlessness in COPD

• Practice performing progressive relaxation techniques

ObjectivesObjectives

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Tension,Anxiety,

&Fear

ExhaustionIncapacitation

Heart Rate IncreasesUse of Oxygen Increases

Bronchospasms

ShortnessOf

Breath

The Importance of RelaxationThe Importance of Relaxation

Source: The Lung Association

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Non-pharmacologic agents used as palliative interventionsto relieve breathlessness.

• Progressive relaxation• Breathing techniques

– Positioning– Diaphragmatic breathing– Purse lip breathing

Non-Pharmacologic AgentsNon-Pharmacologic Agents

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Short-Term & Long Term StressShort-Term & Long Term Stress

Source: Is It Worth Dying For Authors, Dr. Roberts S. Eliot and Dennis L. Breo

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Use of the Sympathetic Nervous System to assist in alleviating the stress of breathlessness. (Involuntary or autonomic nervous system responses)

• Increases blood pressure• Increases heart rate• Rapid shallow breathing• Sweaty palms• Dry mouth

Sympathetic Nervous SystemSympathetic Nervous System

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Parasympathetic Nervous System (voluntary)

• Mediates• Calms• Slows heart rate• Slows breathing

Parasympathetic Nervous SystemParasympathetic Nervous System

The Nervous SystemThe Nervous System

Accelerates RespirationsIn the Lungs

Slows RespirationsIn the Lungs

Outline of some of the effects of the sympathetic and parasympathetic nervous systems on various organs and glands.

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The Nervous SystemThe Nervous System

Accelerates RespirationsIn the Lungs

Slows RespirationsIn the Lungs

Outline of some of the effects of the sympathetic and parasympathetic nervous systems on various organs and glands.

Sympathetic Nervous System

Parasympathetic Nervous System

Lungs

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Anxiety of BreathlessnessAnxiety of Breathlessness

AUTONOMIC NERVOUS SYSTEMS RESPONSES Increased blood pressure Increased heart rate Sweaty palms Dry mouth Enlarged pupils Goose bumps Fast, shallow breathing Sinking feeling

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Progressive RelaxationSystematic relaxation and contraction of specific muscle groups in conjunction with diaphragmatic and pursed lip breathing.


Breathing Techniques• Positioning – instruct client to lean

forward on forearms supporting upper body.

• Diaphragmatic Breathing – leaning forward on forearms, inhale deeply (stomach goes in) hold approximately 3-4 seconds. Use pursed lip breathing to exhale.

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Purse Lip Breathing

Purse lip breathing involves inhalation through the nose followed by a slow exhalation usually 4-6 seconds through pursed lips. Evidence shows decrease air trapping by stenting the airways and preventing dynamic airway collapse averting panic attacks that accompany severe breathlessness.

Progressive Relaxation1. Choose a quiet spot where you will not be disturbed by other

people or telephones.

2. Play soft, soothing music, i.e., nature sounds.

1. Close your eyes. This makes it easier to concentrate.

2. Lean forward to on your arms, supporting the upper body. Take in a deep breath. Your stomach goes in. Exhale. Your stomach moves out. This is diaphragmatic breathing; most people are “chest breathers.” Continue to breathe in and out “slowly” with your diaphragm.

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Progressive Relaxation5. Take in a deep breath, stomach goes in, exhale over 4-6

seconds, slowly through pursed lips (stomach moves out). Continue this part of the exercise for approximately 1-2 minutes.

6. Gradually, begin to tighten your toes and ankles, take in a deep breath (stomach goes in) and tighten toes and ankles; deep breathe out thru pursed lips, relax toes and ankles.

7. As you take in your next breath, tighten your toes, ankles, lower legs… hold it, hold it.

8. Begin to exhale thru pursed lips, relax lower legs, ankles, toes.


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Progressive Relaxation9. As you inhale, (stomach goes in) tighten toes, ankles, lower

legs, thighs… hold your breath, stay tight, tight. Exhale thru pursed lips, relax toes, ankles, lower legs, thighs.

10. Inhale (stomach goes in) and progressively tighten toes, ankles, lower legs thighs, buttocks and tummy. Exhale through pursed lips and relax muscles slowly.

11. Inhale (stomach goes in) and progressively tighten muscles from toes to tummy, and now your chest muscles… exhale through pursed lips and relax muscles.


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Progressive Relaxation12. Inhale (stomach goes in) and progressively tighten muscles

from toes to chest muscles, and now add your arms; tighten your fists, scrunch up your face… hold it… hold it. Exhale (through pursed lips) and progressively relax your muscles.

13. Breathe in and out with your diaphragm 1-2 minutes more.

14. Bend over at the waist, and shake your arms and hands.

15. Slowly open your eyes.


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Progressive RelaxationPerform exercise at least 4 times a day for 3-4 minutes.


Sit still for at least 5 minutes after doing exercise to alleviate possible lightheadedness.

Enjoy!

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Q & Aand

Thank You!

Q & Aand

Thank You!

Education

Stresses of breathlessness