Analysis of Nursing Practice in Clients with Cardiovascular System Disorders: A Primary Case of Congestive Heart Failure with the Implementation of Alternate Nostril Breathing Exercise on Hemodynamic Status
Article Sidebar
Main Article Content
Abstract
Background: Congestive Heart Failure (CHF) is a progressive cardiovascular disorder in which the heart cannot pump blood effectively, leading to impaired hemodynamics and reduced quality of life. Complementary interventions such as Alternate Nostril Breathing Exercise (ANBE) may improve cardiovascular stability through relaxation and oxygenation enhancement.
Methods: This nursing practice was conducted at Pusri Hospital Palembang on a CHF patient. ANBE was performed twice daily for seven consecutive days, with each session lasting 10 minutes under nurse supervision. Hemodynamic parameters including blood pressure, heart rate, respiratory rate, and oxygen saturation were measured before and after each session.
Results: Post-intervention findings showed improved hemodynamic stability, with reductions in blood pressure and heart rate, increased oxygen saturation, and more regular respiratory patterns. The patient also reported feeling calmer and experiencing reduced shortness of breath. These improvements suggest that ANBE effectively supports cardiovascular function in CHF management.
Conclusion: ANBE is a simple, non-invasive, and cost-effective nursing intervention that can be integrated into CHF patient care both in hospital and at home. It has potential as a complementary therapy to enhance hemodynamic stability and overall patient well-being. Further studies with larger populations are recommended to strengthen evidence for its clinical application.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Agne et.al. (2024). Clinical effect of torsemide in a horse with congestive heart failure and atrial fibrillation. Journal of Equine Veterinary Science. Volume 133, February 2024, 105001. Elsevier.
Ahmad, Y., Petrie, M. C., Jolicoeur, E. M., Madhavan, M. V., Velazquez, E. J., Moses, J. W., … Stone, G. W. (2022). Patients with heart failure: current evidence, impact of complete revascularization, and contemporary techniques to improve outcomes. Journal of the Society for Cardiovascular Angiography & Interventions, 1(2), 100020. https://doi.org/10.1016/j.jscai.2022.100020
Alivian, G. N. (2018). Pengaruh light massage dan murottal terhadap perubahan hemodinamik pada pasien dengan gagal jantung di RSUD Prof.Dr. Margono Soekardjo Purwokerto. Universitas Erlangga
American Heart Association. (2021). Heart disease and stroke statistics update fact sheet american heart association research heart disease , stroke and other cardiovascular diseases coronary heart disease (CHD). American Heart Association
Anthony & Rani. (2024). The epidemiological characteristics of sleep disordered breathing in congestive heart failure: A prospective, single centre study in Southeast Asia. Journal of the Royal College of Physicians of Edinburgh. ttps://doi.org/10.1177/14782715241239704.
Attia, et.al. (2024). Heart Failure Versus Renal Failure Patients in Relation to Outcomes of Alternate Nostril Breathing: Comparative Study. Journal of Nursing Science - Benha University ISSN 2682 – 3934 Vol. (5) No. (1) 2024.
Bargal, S., Nalgirkar, V., Patil, A., & Langade, D. (2022). Evaluation of the effect of left nostril breathing on cardiorespiratory parameters and reaction time in young healthy individuals. Cureus, (February). https://doi.org/10.7759/cureus.22351
Centers for Disease Control and Prevention. (2021). Heart Failure. Diambil dari https://www.cdc.gov/heartdisease/heart_failure.htm
Chaddha, A. (2015). Slow breathing and cardiovascular disease. International Journal of Yoga, 8(2), 142. https://doi.org/10.4103/0973-6131.158484
Cornell et.al. (2024). Hand-Held Echocardiography by Advanced Practice Providers in Patients with Congestive Heart Failure. J. Clin. Med. 2024, 13(2), 312; https://doi.org/10.3390/jcm13020312.
Dhanvijay, A. D., Harish Bagade, A., Choudhary, A. K., Kishanrao, S. S., & Dhokne, N. (2015). Alternate nostril breathing and autonomic function in healthy young adults. IOSR Journal of Dental and Medical Sciences, 14(3), 2279–861. https://doi.org/10.9790/0853-14366265
Dhungel, U., & Sohal, A. (2013). Physiology of nostril breathing exercises and its probable relation with nostril and cerebral dominance: A theoretical research on literature. Janaki Medical College Journal of Medical Science, 1(1), 38–47. https://doi.org/10.3126/jmcjms.v1i1.7885
Elgwairi et.al. (2024). Pleural Effusions in Patients With Congestive Heart Failure: Frequency, Pathogenesis, Diagnosis, and Implications. Cardiology in Review 32(2):p 91-96, March/April 2024. | DOI: 10.1097/CRD.0000000000000469
Febtrina, R., & Malfasari, E. (2018). Analisa nilai tanda-tanda vital pasien gagal jantung. Health Care : Jurnal Kesehatan, 7(2), 62–68. https://doi.org/10.36763/healthcare.v7i2.26
Garg et.al. (2024). Effect of breathing exercises on blood pressure and heart rate: A systematic review and meta-analysis. International Journal of Cardiology Cardiovascular Risk and Prevention. Volume 20. Elsevier. https://doi.org/10.1016/j.ijcrp.2023.200232.
Ghiya, S. (2017). Alternate nostril breathing: a systematic review of clinical trials. International Journal of Research in Medical Sciences, 5(8), 3273. https://doi.org/10.18203/2320-6012.ijrms20173523
Hajrah et.al. (2023). Upaya Pengendalian Hipertensi pada Lanjut Usia Melalui Edukasi Perilaku CERDIK dan Gerakan PATUH. Madago Community Empowerment for Health Journal. Volume 3, Nomor 1, Tahun 2023. p-ISSN: 2808-8247& e-ISSN: 2808-7003. DOI: 10.33860/mce.v3i1.3431. http://jurnal.poltekkespalu.ac.id/index.php/mce
Hsu, S., Fang, J. C., & Borlaug, B. A. (2021). Hemodynamics for the heart failure clinician: A State-of-the-art review. Journal of Cardiac Failure, 28(1), 133–148. https://doi.org/10.1016/j.cardfail.2021.07.012
Inawijaya et.al. (2023). Penerapan Teknik Alternate Nostril Breathing Exercise Terhadap Tekanan Darah dan Frekuensi Nafas Pada Pasien CHF Di RSUD Dr Moewardi Surakarta. Jurnal Excellent Volume2Nomor 2 Tahun 2023Halaman 1–10EXCELLENT HEALTH JURNALResearch & Learning in HealthSciencehttp://journal.stkiptam.ac.id/index.php/excellent.
Jain, C. C., & Borlaug, B. A. (2020). Hemodynamic assessment in heart failure. Catheterization and Cardiovascular Interventions, 95(3), 420–428. https://doi.org/10.1002/ccd.28490
Kalaivani, S. K. M. P. G. (2019). Effect of alternate nostril breathing exercise on blood pressure, heart rate, and rate pressure product among patients with hypertension in JIPMER, Puducherry. Journal of Education and Health Promotion, (January), 1–6. https://doi.org/10.4103/jehp.jehp
Khairunisa & Hudiyawati. (2023). Hubungan Antara Kualitas Tidur Dengan Self-Care Pada Pasien Gagal Jantung. Jurnal KeperawatanVolume 15Nomor S4, Desember2023e-ISSN 2549-8118; p-ISSN2085-1049http://journal.stikeskendal.ac.id/index.php/Keperawatan
Khatib, M., Kirubakaran, R., Gaidhane, S., Shankar, A. H., & Quazi Syed, Z. (2017). Yoga for improving functional capacity, quality of life and cardiovascular outcomes in people with heart failure. Cochrane Database of Systematic Reviews, 2017(7), 2–5. https://doi.org/10.1002/14651858.CD012015.pub2
Lippi, G., & Gomar, F. S. (2020). Global epidemiology and future trends of heart failure, (Ci), 2–7. https://doi.org/10.21037/amj.2020.03.03
Majid, A. (2018). Asuhan keperawatan pada pasien dengan gangguan sistem kardiovaskular. Yogyakarta: Pustaka Baru Press.
Meilani & Ernawati. (2024). Penerapan Discharge Planning Aplikasi Cardicraf terhadap Tingkat Pengetahuan Self-Management Pasien Gagal Jantung Kongestif (CHF). Jurnal KeperawatanVolume 16Nomor 4, Desember2024e-ISSN 2549-8118; p-ISSN2085-1049http://journal.stikeskendal.ac.id/index.php/Keperawatan.
Moses et.al. (2023). Time-domain heart rate variability features for automatic congestive heart failure prediction. Volume11, Issue 1 February 2024. Pages 378-389. ESC Heart Failure. Wiley Online Library. https://doi.org/10.1002/ehf2.14593.
Mooventhan, A., & Nivethitha, L. (2017). Evidence based effects of yoga practice on various health related problems of elderly people: A review. Journal of Bodywork and Movement Therapies, 21(4), 1028–1032. https://doi.org/10.1016/j.jbmt.2017.01.004
Mufarida, B. (2022). Covid-19 Lewat, Menko PMK Sebut Kanker Jadi Penyebab Kematian Tertinggi di Indonesia. Diambil dari https://www.kemkes.go.id/article/view/19093000001/penyakit-jantung-penyebab-kematianterbanyak-ke-2-di-indonesia.html
Novitasari et.al. (2023). Pengaruh Alternate Nostril Breathing Exercise Terhadap Frekuensi Napas Pada Pasien Congestive Heart Failure. Jurnal Ners Volume 7 Nomor 1Tahun 2023 Halaman 110 – 115. JURNAL NERS. Research & Learning in Nursing Science. http://journal.universitaspahlawan.ac.id/index.php/ners
Permana et.al. (2024). Profil Pengobatanpasien Geriatri Diabetes Melitus Dengan Penyakit Penyerta Di Instalasi Farmasi Rawat Jalan RS PKU Muhammadiyah Sruweng. Volume 5, Nomor1, Maret 2024. ISSN : 2774-5848 (Online)ISSN : 2777-0524 (Cetak).
Price, S. ., & Wilson, L. . (2013). Patofisiologi konsep klinis proses-proses penyakit (Edisi VI). Jakarta: EGC.
Rogers, C. (2015). Heart failure : Pathophysiology, diagnosis, medical treatment guidelines, and nursing management. Nursing Clinics of NA, 50(4), 787–799. https://doi.org/10.1016/j.cnur.2015.07.012
Royani, et.al. (2023). penerapan alternate nostril breathing exercise (ANBE) terhadap respiration ratepada pasien CHF. Jurnal Imliah Ilmu Kesehatan. Vol.1, No. 3 Juni, 2023.
Sa et.al. (2024). Impact of mental disorders on unplanned readmissions for congestive heart failure patients: a population-level study. ESC Heart Failure 2024; 11: 962–973. Published online 16 January 2024 in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/ehf2.14644
Savarese, G., Becher, P. M., Lund, L. H., Seferovic, P., Rosano, G. M. C., & Coats, A. J. S. (2022). Global burden of heart failure: A comprehensive and updated review of epidemiology. Cardiovascular Research, 1–16. https://doi.org/10.1093/cvr/cvac013
Setiyawan. (2016). Mean arterial pressure non invasif blood pressure (MAP-NIBP ) pada lateral position dalam perawatan intensif : Studi literature. Prodi S-1 Keperawatan STIKes Kusuma Husada Surakarta, 5, 565–569.
Shao et.al. (2024). The Efect of Slow‑Paced Breathing on Cardiovascular and Emotion Functions: A Meta‑Analysis and Systematic Review. Mindfulness (2024) 15:1–18. https://doi.org/10.1007/s12671-023-02294-2.
Sharma et.al. (2024). CHF: A Disease Capturing Indians. Scholars Academic Journal of Pharmacy. Abbreviated Key Title: Sch Acad J Pharm. ISSN 2347-9531 (Print) | ISSN 2320-4206 (Online). Journal homepage: http://saspublishers.com
Simandalahi, T., Morika, H. D., & Fannya, P. (2019). The effect of alternate nostril breathing exercise in vital signs of congestive heart failure patients. International Journal Of Community Medicine And Public Health, 7(1), 67. https://doi.org/10.18203/2394-6040.ijcmph20195834
Suranata, F. M., Waluyo, A., Jumaiyah, W., & Natashia, D. (2019). Slow deep breathing dan alternate nostril breathing terhadap penurunan tekanan darah pada pasien hipertensi. Jurnal Keperawatan Silampari, 2(2), 160–175. https://doi.org/10.31539/jks.v2i2.702
Syafriati, A. (2023). Keperawatan Medikal Bedah Sistem Kardiovaskuler. Palembang : Morgensonne Media.
Syafriati & Gustini. (2022). Manajemen Upaya Pasien Congestive Heart Failure Dalam Mengatasi Ketidakstabilan Hemodinamik. Palembang : Morgensonne Media.
Syafriati & Anggraeni. (2022). Manajemen Gagal Jantung Kongestif (Congestive Heart Failure). Palembang : Morgensonne Media.
Uğur, G. (2020). The effect of alternate nostril breathing exercise on regulation of blood pressure in individuals with hypertension. Journal of Cardiovascular Nursing, 11(26), 125–131. https://doi.org/10.5543/khd.2020.92905
Verbrugge, F. H., Guazzi, M., Testani, J. M., & Borlaug, B. A. (2020). Altered hemodynamics and end-organ damage in heart failure: impact on the lung and kidney. Circulation, 142(10), 998–1012. https://doi.org/10.1161/CIRCULATIONAHA.119.045409
Wijayanti & Gati. (2023). Penerapan Aktivitas Jalan Pagi Terhadap Tekanan Darah Pada Penderita Hipertensi Lanjut Usia Di Desa Bendungan Kabupaten Sragen. DIAGNOSA: Jurnal Ilmu Kesehatan dan Keperawatan. Vol.1, No. 4 November 2023. e-ISSN: 2986-3597; p-ISSN: 2986-4488, Hal 26-38. DOI: https://doi.org/10.59581/diagnosa-widyakarya.v1i4.1266
Wirakhmi & Purnawan. (2023). Hubungan Aktivitas Fisik dengan Hipertensi Pada Lanjut Usia di Puskesmas Kutasari. Jurnal Untuk Masyarakat Sehat (JUKMAS) e-ISSN : 2715-7687. Vol. 7, No. 1 April 2023. P-ISSN : 2715-8748
World Health Organization. (2021). Cardiovascular Diseases. Diambil dari https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds).
World Heart Federation. (2021). Cardiovascular Disease. Diambil dari https://world-heart-federation.org/where-we-work/south-east-asia/#:~:text=Cardiovascular disease accounts for nearly,%25 of CVD-related deaths.
Yunia et.al. (2023). Intervensi Teknik Alternate nostril breathing Terhadap Penurunan Tekanan Darah pada Pasien Hipertensi. Journal Keperawatan Degeneratif. http://ejournal.akper-pelni.ac.id/index.php/jkp. Vol. 01, No. 1. Agustus 2023. Received July 2023; Accepted August 2023.
Zhang et.al. (2024). U-shaped association between serum calcium and inhospital mortality in patients with congestive heart failure. ESC Heart Failure (2024). Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/ehf2.14730
Zhao, D. (2021). Epidemiological features of cardiovascular disease in asia. JACC: Asia, 1(1), 1–13. https://doi.org/10.1016/j.jacasi.2021.04.007