Which options describes orthopnea?

Appeared in: NVS Staff Nurse - 2019

Explanation

Orthopnea is the medical term for shortness of breath that occurs when lying flat.
The condition is relieved promptly by sitting up or standing.
It is caused by the redistribution of fluid from the lower body to the chest when in a recumbent position, which increases pressure in the lungs.
This symptom is a hallmark sign of left ventricular heart failure, as the weakened heart cannot handle the increased venous return.

Option B: This describes bradypnea, which is an abnormally slow breathing rate (typically less than 12 breaths per minute in an adult).
Option C: This is the definition of dyspnea, which is the general medical term for difficulty in breathing or shortness of breath. Orthopnea is a specific type of dyspnea that is related to body position.
Option D: This describes Cheyne-Stokes respiration, an abnormal breathing pattern characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing (apnea).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Definition of Orthopnea and Differentiation from other Respiratory Patterns as background academic context rather than a clinical decision trigger.
A key nursing assessment for a patient reporting shortness of breath is to ask about orthopnea, specifically, 'How many pillows do you sleep on at night?' The number of pillows can quantify the severity of the condition.
Orthopnea is a critical finding that strongly suggests left-sided heart failure and requires prompt medical evaluation and intervention to manage fluid overload.
What if? If a patient with orthopnea also presents with jugular venous distension (JVD) and pitting edema in the legs, it indicates that right-sided heart failure has also developed, leading to a diagnosis of congestive heart failure (biventricular failure).

How to Approach the Question

First, identify the key term in the question: 'orthopnea'.
Recall the definition of orthopnea. It is a specific type of breathing difficulty related to posture.
Evaluate each option against this definition.
Option A directly matches the definition: difficulty breathing except when upright.
Eliminate the other options by identifying the correct medical term for each description: 'Slow breathing' is bradypnea, 'Difficulty in breathing' is the general term dyspnea, and 'Rhythmic waxing and waning' is Cheyne-Stokes respiration.
Confirm that Option A is the most precise and accurate description of orthopnea.

Concept Tested & Keywords

Concept Tested: Definition of Orthopnea and Differentiation from other Respiratory Patterns
Stem keywords: orthopnea, describes
Lead-in keywords: Which options
Negative lead-in flag: false

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E6 Medicine Harrison 22e Part 1 p. 2023-2025

E6 Nursing Fundamentals Taylor p. 360-362

Practise the full NVS Staff Nurse - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.