A patient with left-sided heart failure is experiencing dyspnea. Which nursing intervention is most appropriate to improve breathing?

• A. Encourage the patient to cough and deep breathe.
• B. Place the patient in Semi-Fowler's position.
• C. Assist the patient into High Fowler's position.
• D. Perform chest percussion therapy.

Answer: (C)

When a patient with left-sided heart failure has dyspnea, the priority is to maximize ventilation and ease the workload of breathing. Elevating the head of the bed into a High Fowler's position—head of bed high enough to bring the torso near upright—best accomplishes this. Being upright allows the chest wall to expand more fully, improves diaphragmatic movement, and reduces the work the heart and lungs must do to oxygenate the blood. It often provides quicker relief of shortness of breath and makes it easier for the patient to receive any prescribed oxygen or medications.

Encouraging cough and deep breathing is helpful for preventing atelectasis over time but doesn’t directly relieve pulmonary edema-related dyspnea. A Semi-Fowler's position offers some improvement but not to the extent of High Fowler's. Chest percussion therapy targets secretions and is not the primary intervention for relief of dyspnea due to fluid in the lungs.