How should a nurse assess a patient for dyspnea as part of end-of-life care?

Assessing a patient for dyspnea, especially in the context of end-of-life care, is a highly sensitive process that centers on the patient's subjective experience. Asking the patient about their breathing taps directly into their perception of dyspnea, which can include feelings of shortness of breath, tightness in the chest, or a sense of increased effort in breathing. This direct communication allows for a nuanced understanding of their symptoms, which is particularly important in palliative care where the patient’s comfort and quality of life are primary concerns.

While measuring oxygen saturation levels, observing the patient’s color, and noting respiratory rate provide valuable clinical information, they do not capture the subjective experience of breathlessness as effectively as directly asking the patient. Patients may have normal oxygen saturation levels or stable respiratory rates yet still experience significant discomfort. Hence, engaging with the patient about their sensations of breathing is essential for obtaining a comprehensive view of their respiratory status and addressing their needs appropriately.