Pursed-Lips Breathing and High Fowler Position in Pleural Effusion Patient: Case Report

Syahratul Janah, Hesti Platini, Siti Ulfah Rifaatul Fitri

Abstract


Pleural effusion is a collection of fluid in the pleura caused by the impact of another disease. Treatment for pleural effusion can be provided through the nursing care process with airway management interventions to help minimize shortness of breath in patients. There are nursing actions that can be carried out independently by nurses, namely the semi-fowler or fowler position, administering additional oxygen, and other therapies such as pursed lips breathing. The aim of this research is to determine the effectiveness of the combination of pursed lips breathing and high fowler position in the nursing care process for patients with ineffective airway clearance nursing problems in patients with pleural effusion using the case report method and nursing care approach. The results of the study showed that the combination of pursed lips breathing and the use of the selected high fowler position as high as 90 degrees for 3 days provided comfort and reduced shortness of breath with pleural effusion while being balanced by the provision of pharmacological therapy. Providing pursed lips breathing therapy and high fowler position has the potential to reduce shortness of breath in patients with pleural effusion

Keywords


pleural effusion, high fowler position, pursed lips breathing, shortness of breath

Full Text:

PDF

References


Adawiah, A. Z., & Yanto, A. (2021). Perubahan frekuensi pernafasan dan saturasi oksigen pada klien dengan asma menggunakan terapi pursed-lip breathing. Ners Muda, 2(3), 113. https://doi.org/10.26714/nm.v2i3.6325

Ai, L., Wang, W., Li, J., Ye, T., & Li, Y. (2024). Use of tumor markers in distinguishing lung adenocarcinoma-associated malignant pleural effusion from tuberculous pleural effusion. The American Journal of the Medical Sciences. https://doi.org/https://doi.org/10.1016/j.amjms.2024.04.001

Alboksmaty, A., Beaney, T., Elkin, S., Clarke, J., Darzi, A., Aylin, P., & Neves, A.-L. (2022). Effectiveness and safety of pulse oximetry in remote patient monitoring of patients with COVID-19: a systematic review. Lancet Digital Health, 4(April), 279–289.

Amalakanti, S., & Pentakota, M. R. (2016). Pulse oximetry overestimates oxygen saturation in COPD. Respiratory Care, 61(4), 423–427. https://doi.org/10.4187/respcare.04435

Anevlavis, S., Varga, C., Nam, T. H., Man, R. W. C., Demetriou, A., Jain, N., Lanfranco, A., & Froudarakis, M. E. (2019). Is there any role for thoracoscopy in the diagnosis of benign pleural effusions. Clinical Respiratory Journal, 13(2), 73–81. https://doi.org/10.1111/crj.12983

Anggarsari, Y. D., Setyorini, Y., & Rifai, A. (2018). Studi Kasus Gangguan Pola Napas Tidak Efektif Pada Pasien Efusi Pleura. Interest : Jurnal Ilmu Kesehatan, 7(2), 168–179. https://doi.org/10.37341/interest.v7i2.31

Aulia, H. D., Pratiwi, S. H., & Sari, E. A. (2023). Intervensi Pursed-Lip Breathing dan Posisi High Fowler untuk Mengatasi Gejala Sesak Napas pada Pasien dengan Coronary Artery Disease: Sebuah Studi Kasus. MAHESA : Malahayati Health Student Journal, 3(9), 2633–2645. https://doi.org/10.33024/mahesa.v3i9.10894

Calverley, P., Rogliani, P., & Papi, A. (2021). Safety of N-Acetylcysteine at High Doses in Chronic Respiratory Diseases: A Review. Drug Safety, 44(3), 273–290. https://doi.org/10.1007/s40264-020-01026-y

Campbell, M. L. (2017). Dyspnea. Critical Care Nursing Clinics of North America, 29(4), 461–470. https://doi.org/10.1016/j.cnc.2017.08.006

Chanif, C., & Prastika, D. (2019). Position of Fowler and Semi-fowler to Reduce of Shortness of Breath (Dyspnea) Level While Undergoing Nebulizer Therapy. South East Asia Nursing Research, 1(1), 14. https://doi.org/10.26714/seanr.1.1.2019.14-19

Claudio, S., Mondoni, M., Lococo, F., Marchetti, G., & Feller-Kopman, D. (2022). Optimizing the management of complicated pleural effusion: From intrapleural agents to surgery. Respiratory Medicine, 191(November 2021), 106706. https://doi.org/10.1016/j.rmed.2021.106706

Elsayed, A., Elmarasi, M., Hamad, A., & Habib, M. B. (2023). Recurrent asymptomatic large pleural effusion due to endometriosis. A case report. Respiratory Medicine Case Reports, 44. https://doi.org/10.1016/j.rmcr.2023.101877

Feller-Kopman, D., & Light, R. (2018). Pleural Disease. New England Journal of Medicine, 378(8), 740–751. https://doi.org/10.1056/NEJMra1403503

Ferreiro, L., Suarez-Antelo, J., Manuel, J., E. Toubes, M., Vanessa, R., & Valdes, L. (2020). Malignant pleural effusion diagnosis and therapy. Canadian Respiratory Journal, 18(1), 1–11. https://doi.org/10.1515/biol-2022-0575

Fitriawanda, A. N., & Sutrisno, R. Y. (2022a). “Strengthening Youth Potential for Sustainable Innovation” 96 Efektifitas Pursed Lip Breathing Exercise Dan Posisi Fowler Pada Pasien Asthma: Studi Kasus (Issue 2).

Fitriawanda, A. N., & Sutrisno, R. Y. (2022b). “Strengthening Youth Potential for Sustainable Innovation” 96 Efektifitas Pursed Lip Breathing Exercise Dan Posisi Fowler Pada Pasien Asthma: Studi Kasus. ProceedingsThe 3rdUMY Grace 2022, 2(2), 96–101.

Gayen, S. (2022). Malignant Pleural Effusion: Presentation, Diagnosis, and Management. The American Journal of Medicine, 135(10), 1188–1192. https://doi.org/10.1016/j.amjmed.2022.04.017

Godskesen, T., Björk, J., & Juth, N. (2023). Challenges regarding informed consent in recruitment to clinical research: a qualitative study of clinical research nurses’ experiences. Trials, 24(1), 1–12. https://doi.org/10.1186/s13063-023-07844-6

Hess, M. W. (2023). Oxygen Therapy in COPD. Respiratory Care, 68(7), 998–1012. https://doi.org/10.4187/respcare.10876

Jany, B., & Welte, T. (2019). Pleural effusion in adults - Etiology, diagnosis, and treatment. In Deutsches Arzteblatt International (Vol. 116, Issue 21, pp. 377–386). Deutscher Arzte-Verlag GmbH. https://doi.org/10.3238/arztebl.2019.0377

Karim, B. A., Aini, I., & Azzahra, F. (2022). Penerapan Relaksasi Benson Dan Pursed Lip Breathing Pada Lansia Yang Mengalami Hipertensi. Jurnal Keperawatan Sriwijaya, 9(2), 18–24. https://doi.org/10.32539/jks.v9i2.151

Katz, S., Arish, N., Rokach, A., Zaltzman, Y., & Marcus, E. L. (2018). The effect of body position on pulmonary function: A systematic review. BMC Pulmonary Medicine, 18(1), 1–16. https://doi.org/10.1186/s12890-018-0723-4

Mayer, A. F., Karloh, M., dos Santos, K., de Araujo, C. L. P., & Gulart, A. A. (2018). Effects of acute use of pursed-lips breathing during exercise in patients with COPD: a systematic review and meta-analysis. Physiotherapy (United Kingdom), 104(1), 9–17. https://doi.org/10.1016/j.physio.2017.08.007

Mendes, L. P. S., Moraes, K. S., Hoffman, M., Vieira, D. S. R., Ribeiro-Samora, G. A., Lage, S. M., Britto, R. R., & Parreira, V. F. (2019). Effects of diaphragmatic breathing with and without pursed-lips breathing in subjects with COPD. Respiratory Care, 64(2), 136–144. https://doi.org/10.4187/respcare.06319

Nguyen, J., & Duong, H. (2020). Pursed-lip Breathing. In StatPearls. http://www.ncbi.nlm.nih.gov/pubmed/31424873

Pranita, N. P. N. (2020). Diagnosis dan tatalaksana terbaru penyakit pleura. Wellness And Healthy Magazine, 2(1), 69–78. https://doi.org/10.30604/well.58212020

Puspita, I., Umiana Soleha, T., & Berta, G. (2017). Penyebab Efusi Pleura di Kota Metro pada tahun 2015. In J AgromedUnila | (Vol. 4).

Roberts, S. E., Schreuder, F. M., Watson, T., & Stern, M. (2017). Do COPD patients taught pursed lips breathing (PLB) for dyspnoea management continue to use the technique long-term? A mixed methodological study. Physiotherapy (United Kingdom), 103(4), 465–470. https://doi.org/10.1016/j.physio.2016.05.006

Rozak, F., Clara, H., Keperawatan, D., Bedah, M., Keperawatan, A., & Rebo, P. (2022). Studi Kasus : Asuhan Keperawatan Pasien Dengan Efusi Pleura. Buletin Kesehatan, 6(1), 87–101.

Sidiq, M. F., Agustina, H., & Kulsum, I. D. (2020). Profil Klinis, Gambaran Makroskopis dan Mikroskopis Cairan Efusi Pleura pada Pasien Rawat Inap di Departemen Ilmu Penyakit dalam RSUP DR. Hasan Sadikin Bandung Periode Januari 2016-Desember 2018. Indonesia Journal Chest , 7(1), 1–10.

Supardi, E., Handayani, D. E., Sariama, & Astuti. (2023). Penerapan Pursed Lip Breathing Dalam Pemenuhan Kebutuhan Oksigen (Pola Napas Tidak Efektif) Pada Pasien Ppok. Jawara (Jurnal Ilmiah Keperawatan), 4(3), 1–9.

Tilaar, E., Tangkilisan, A., Tamburian, C., Korompis, G., Pendidikan Dokter Spesialis Bagian Bedah Fakultas Kedokteran Universitas Sam Ratulangi, P., Bedah Toraks Kardio Vaskular, D., Bedah, B., Kedokteran, F., Sam Ratulangi, U., & Kesehatan Masyarakat, F. (2023). Faktor Prognostik pada Efusi Pleura Ganas Berdasarkan Skor LENT di RSUP Prof. Dr. R. D. Kandou Manado Prognostic Factors in Malignant Pleural Effusion Based on LENT Score at Prof. Medical Scope Journal, 5(2), 253–258.

Ustami, L., & Nurhakim, F. (2023). Intervensi Manajemen Jalan Napas Pada Pasien Dengan Bersihan Jalan Napas Tidak Efektif : Studi Kasus. Jurnal Riset Ilmiah, 2(7), 2638–2643.

Veronika, E., Ira, M. K. M., Ayu, M., & Epid, M. (2019). Disain Studi Deskriptif (Vol. 9).

Wang, S., Tian, S., Li, Y., Zhan, N., Guo, Y., Liu, Y., Xu, J., Ma, Y., Zhang, S., Song, S., Geng, W., Xia, H., Ma, P., Wang, X., Liao, T., Duan, Y., Jin, Y., & Dong, W. (2020). Development and validation of a novel scoring system developed from a nomogram to identify malignant pleural effusion. EBioMedicine, 58. https://doi.org/10.1016/j.ebiom.2020.102924

Windiramadhan, A. P., Sicilia, A. G., Afirmasari, E., Hartati, S., Platini, H., & Hamidah. (2020). OBSERVASI Penggunaan Posisi High Fowler pada Pasien Efusi Pleura Di Ruang Perawatan Penyakit dalam Fresia 2 RSUP DR.Hasan Sadikin Bandung : Studi Kasus. Jurnal Perawat Indonesia , 4(1), 329–338.

Wysham, N. G., Miriovsky, B. J., Currow, D. C., Herndon, J. E. 2nd, Samsa, G. P., Wilcock, A., & Abernethy, A. P. (2015). Practical Dyspnea Assessment: Relationship Between the 0-10 Numerical Rating Scale and the Four-Level Categorical Verbal Descriptor Scale of Dyspnea Intensity. Journal of Pain and Symptom Management, 50(4), 480–487. https://doi.org/10.1016/j.jpainsymman.2015.04.015

Zhou, J., Chen, N., Hai, Y., Lyu, M., Wang, Z., Gao, Y., Pang, L., Liao, H., & Liu, L. (2019). External suction versus simple water-seal on chest drainage following pulmonary surgery: An updated meta-analysis. Interactive Cardiovascular and Thoracic Surgery, 28(1), 29–36. https://doi.org/10.1093/icvts/ivy216




DOI: https://doi.org/10.37311/jnj.v6i2.25559

Refbacks

  • There are currently no refbacks.


Copyright (c) 2024 Syahratul Janah

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.