Nursing Care of Patients with Pulmonary Fibrosis

         Caring for a patient with pulmonary fibrosis can be a challenging experience because the disease doesn’t exactly have a cure. Most of the care given to these patients is meant to help them be more comfortable. While giving nursing care for these patients there are a few things that you should always remember. First off most of the patients with pulmonary fibrosis are older so you should always look into any other problems they may have or any additional medications they could be on. There are also a lot of co-morbities that go along with pulmonary fibrosis that you need to look out for. These include gastroesophageal reflux disease (GERD), pulmonary hypertension, coronary artery disease, diabetes, lung cancer, obstructive sleep apnea and other sleep disturbances, pulmonary embolism, and emphysema

         Dyspnea or shortness of breath is another problem that many patients with pulmonary fibrosis have. As a nurse it is always a good idea to evaluate your patients for any shortness of breath or any exercise induced trouble breathing. If they have either of these you can try to get them a referral for oxygen therapy so they can be more comfortable while doing things inside and outside. A group of exercises called pulmonary rehabilitation can also be helpful with dyspnea.

         Many pulmonary fibrosis patients also get a very uncomfortable and annoying cough. This symptoms is a bit hard to treat but studies have shown that oral corticosteroids, mucolytic drugs, and codeine are helpful. Fatigue and de-conditioning are also very common with pulmonary fibrosis patients. This happened to them mostly because of low oxygen levels that then lead to muscle de-conditioning. The best way to treat this is by giving supplemental oxygen and to prescribe them to rehabilitation.

         The last common symptom of pulmonary fibrosis that needs special nursing care is depression and anxiety. Because of the poor prognosis and lack of cure of pulmonary fibrosis many patients experience depression. As a nurse it is extremely important to pay close attention to patients and to keep them very well educated about their disease. If they show any signs of depression it is best to refer them to psychosocial support.

         Pulmonary fibrosis is a horrible disease and there are many things that you need to pay close attention to as a nurse but some of the most important things to do are to keep the patient educated and to encourage them to speak up if they are having any problems. A great website for patient education can be found at http://www.medscape.com/viewarticle/748592. This website is really helpful because it has information that is both informative and helpful. It helps explain the problems one may be experiencing and it also gives ways to fix these problems.

Disease centered management	Education and Self-Management	Symptom-Centered Management
Pharmacologic Therapy	Knowledge	Dyspnea
Non Pharmacologic Therapy	Values and preferences	Cough
Co-Morbidities and Complications	Advanced care planning	Fatigue and Deconditioning
Preventative care		Depression and Anxiety

References:

Lee, Joyce, Sally Mclaughlin, and Harold Collard. "Comprehensive Care of the Patient with Idiopathic Pulmonary Fibrosis." Medscape Log In. 1 Jan. 2011. Web. 22 Feb. 2015. <http://www.medscape.com/viewarticle/748592>.

 "Management of Idiopathic Pulmonary Fibrosis." Web. 22 Feb. 2015. <http://www.nursingtimes.net/Journals/2014/04/11/p/n/x/160414-Management-of-idiopathic-pulmonary-fibrosis.pdf>.