Caring for the Patient With Cancer at Home

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Shortness of breath

If the patient is having trouble breathing, the body might not get enough oxygen. Either the lungs can’t take in enough air, or the body can’t get enough oxygen through the bloodstream. A number of different problems can cause this, including chronic lung disorders, blocked airways, pneumonia, weak breathing muscles, or obesity. It can also be caused by pain, immobility, poor nutrition, stress or anxiety, allergic reactions, surgery, anemia, the side effects of chemo or radiation treatment, a tumor, fluid in the lungs, heart failure, and other problems.

What to look for

  • Shortness of breath or trouble breathing when resting, eating, or talking, or with exercise
  • Chest pain
  • Faster breathing
  • Faster heartbeat
  • Pale or bluish-looking skin, fingernail beds, and mouth
  • Cold and clammy feeling skin
  • Nostrils flaring when inhaling
  • Wheezing

What the patient can do

  • Stay calm.
  • Sit up or raise the upper body to a 45° angle by raising the bed or using pillows.
  • Take medicine or treatments prescribed for breathing (for example, oxygen, medicine for relief of wheezing, inhalers, or nebulizers).
  • If you are not in a lot of distress, check your temperature and pulse.
  • Inhale deeply through your nose and exhale through pursed lips for twice as long as it took to inhale. (This is called pursed-lip breathing.)
  • If you are still not breathing easier after 5 minutes, sit up on the side of the bed, with your feet resting on a stool, arms resting on an overbed table or side table with pillows on it, and your head tilted slightly forward.
  • If you’re coughing and spitting, note the amount of sputum and what it looks and smells like.
  • Talk with your doctor about how your breathing problem affects you, especially if you avoid some of your usual activities to keep from getting out of breath.
  • Try muscle relaxation to reduce anxiety. Anxiety makes breathing problems worse. (See the section called “Anxiety, fear, and emotional distress.”)
  • If you keep having trouble breathing, ask your doctor about medicines you can use to help.
  • If new shortness of breath starts suddenly and does not get better; your skin looks pale or blue; or if you have chest discomfort, trouble speaking, dizziness, or weakness, call 911.

What caregivers can do

  • Using a watch with a second hand to check the patient’s pulse, count the number of beats per minute. (If you also count the number of breaths per minute, do it without telling the patient. If the patient knows when you are counting, they may slow down or speed up breathing without realizing it.)
  • Check the patient’s temperature to see if they have a fever.
  • If the patient is short of breath, remove or loosen tight clothing.
  • Have the patient sit up in a resting position that feels comfortable to them.
  • Remind them to breathe in slowly and deeply, then exhale slowly.
  • Remove the patient from extreme temperatures, especially heat, that can make it harder to breathe.
  • Note when the patient gets out of breath (during strenuous activity, normal activity, or when they are at rest), and if it happens when the patient is standing, sitting, or lying down.
  • Putting the patient in front of an open window or placing a fan that blows gently on the face may help some people.
  • Offer medicines or inhalers prescribed for shortness of breath.
  • If home oxygen is prescribed, be sure that you know how to set it up and what flow rate to use. (Do not change the flow rate without first talking to the doctor.) Don’t allow smoking or fire when oxygen is in use.

Call the doctor if the patient:

  • Has trouble breathing or chest pain
  • Has thick, yellow, green, and/or bloody sputum
  • Develops pale or bluish skin, nail beds, or mouth; or if their skin feels cold and clammy
  • Has a fever of 100.5° F or higher when taken by mouth
  • Has flared nostrils during breathing
  • Becomes confused or restless
  • Has trouble speaking
  • Has dizziness or weakness
  • Has swelling of the face, neck, or arms
  • Develops wheezing

Last Medical Review: 11/05/2013
Last Revised: 11/05/2013