Pulmonary heart disease, referred to as pulmonary heart disease, is due to chronic lesions of the bronchial tubes, lungs, thorax or pulmonary arteries due to increased circulatory resistance, pulmonary hypertension, and then make the right ventricle hypertrophy, enlargement, and even the occurrence of the right heart failure heart disease, which has many comorbidities, high morbidity and mortality, and the condition of the easy to change, changeable. Therefore, the observation of the condition is very important. Especially at night, influenced by various factors, it is easy to ignore the importance of nursing observation. First, the analysis of night care 1, the patient’s own pathophysiological characteristics of the vagus nerve excitation at night, the cerebral cortex on the respiratory center regulation function of the relative decline, prompting the occurrence or aggravation of expiratory failure, due to the nighttime sleep, the increase in the amount of return blood, the diaphragm upward, aggravating the burden on the heart. 2, nursing staff factors Nurses are mostly women, physical strength is weak, once a month physiological period, night biological clock disorders, the body is extremely sleepy, one person on duty at night, no one to supervise, if there is no strong sense of responsibility, good moral cultivation and self-control, easy to relax the patient’s observation. 3, the reasons of escorting the night escort often can not adapt to the disorders of the biological clock and sleepy sleep, it is difficult to provide information on the changes. Observation and nursing care 1, expectoration and humidification, in order to maintain the smoothness of the respiratory tract, sputum is easy to occur at night, concentration and aggregation, coupled with the bottom of the sputum expectoration function, coughing and coughing reflexes weakened to the respiratory secretion is difficult to discharge, the airway resistance increases, aggravating the condition. 2.Oxygen therapy nursing observation: continuous low-flow oxygen intake, the patient is asleep at night, the oxygen tube is easy to fall off, obstruction, often check to keep clear, do a good job of family missionary work, can not be adjusted oxygen flow, to ensure that the oxygen therapy is carried out normally. Oxygen therapy process should be closely observed vital signs, cyanosis and other conditions, in order to better adjust the oxygen flow or concentration. Closely observe the changes of mental state and spirit, and find that the patients are drowsy, irritable, in a trance, and sleepy at night, which are the early clinical manifestations of pulmonary encephalopathy. 4.Do a good job of resuscitation of critical patients, prepare suction tube, tracheal intubation, ventilator, in order to timely rescue the patient. 5, careful use of sedative sleeping drugs, patients should be vigilant when the irritability of the callous failure, do not arbitrarily take sleeping pills, sedative drugs, in order to avoid triggering or aggravating the condition.