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A related community nurse interventions and treatment plan

This paper is going to illustrate a research study about pulmonary fibrosis, which has been chosen during fourteen days of medical practicum by delivering the medical history of the individual, identify the condition, Incidence and Prevalence, symptoms, associated risk factors, analysis, treatments, and reduction. Moreover, it will represent a related community nurse interventions and health care plan.

Medical History:

O. A is a 67 years of age Emirate male, born on 1/01/1943 that arrived to the poly clinics in Tawam hospital on 26/11/2010 accompanied along with his son, complaining of chest pain, shortness of breathing, dry cough and impaired movement. He has a earlier medical history of Idiopathic pulmonary fibrosis, Pulmonary Artery Hypertension (PAH), chronic kidney disease, diabetic nephropathy, hyperlipidemia, overweight, orthostatic hypotention, orthopnea, diabetes mellitus tybe2, Coronary Artery Disease, mild Congestive Heart Inability, and dilated Right Ventricle. Furthermore, the social record for O. A is ex girlfriend or boyfriend smoker 2packs/day going back 30-40 calendar year. He just quit 3 years again. While about his family history he explained "my family is healthy, I just have a diabetic brother". The physician bought a 6 minute walk test (to judge the patient talents and dysfunction) and a pulmonary function test. The patient is on 2L air and medications include insulin needles, Emollient, Diltiazem, Ciprofloxacin oral, Lisinopril and others.

Idiopathic pulmonary fibrosis (IPF) is" a progressive and generally fatal disease seen as a scarring of the lungs that thickens the lining of the lungs, causing an irreversible lack of the cellss ability to transport oxygen". (Coalition for Pulmonary Fibrosis, 2009). IPF also called cryptogenic fibrosing alveolitis (CFA), and Typical interstitial pneumonitis (UIP). (Adam Multi-media Encyclopedia, 2010). For the combat trip against pulmonary fibrosis disease, doctors and patients hope to identify the condition etiology. If doctors and examination failed to identify the disease causes then your condition is named Idiopathic pulmonary fibrosis. The disease process differ from patient to another due different facets, in a few patient the disease progress fast, in others it is sluggish, and it could de firm for few years before progressing. The disease process change from patient to another depending on different factors, in some patient the disease progress fast, in others it is sluggish, and it can be stable for couple of years before progressing. An IPF patient may live 3 to 5 5 years (National Center Lung and Blood vessels Institute, 2009).

The few volume of researches conducted to calculate the number of patients with pulmonary fibrosis and the non-efficiency research led to a lack of information about people who have pulmonary fibrosis. One of the latest researches, that have been held in america, approximated the prevalence of IPF about 128, 000 people. (Pulmonary Fibrosis Foundation, 2009). Also, another review done in america on 2000 estimated the number of new situations and the total amount of existed circumstances of IPF patient is 14. 0 and 6. 8 North american for each and every 100, 000 person of the population (Raghu, Weycker, Edelsberg, Bradford, & Oster, 2006).

Although it is idiopathic pulmonary fibrosis but doctors were able to identify the contributing factors that increase the threat of having pulmonary fibrosis. For instance being a smoker or a poor smoker would increase the odds. Also genetic play a role, some studies revealed that pulmonary fibrosis can be hereditary. Moreover, in many reports people developed pulmonary fibrosis after developing a viral disease (mayo center staff, 2009). In addition, Chemicals or toxins And Drugs or rays can lead to pulmonary fibrosis on the long term (Drugs information Online, 2010).

It is essential for nurses to recognize pulmonary fibrosis signs and symptoms. According to the USA Today (2010) the most common symptoms are shortness of breath, dyspnea which is difficulty in respiration, cough, cyanotic pores and skin, chest pain, fatigue, fever, Loss of hunger and weight, clubbed fingers, cardiac disease, and infections.

Idiopathic pulmonary fibrosis complication include Low blood-oxygen levels, pulmonary hypertension, Right-sided heart failure, and Respiratory system failure (mayo clinic staff, 2009).

Diagnosis and tests

Patient may experience a number of diagnostic method. Those diagnostic methods include Arterial Blood vessels Gas Studies in which a blood sample is taken from an artery mainly from patient arm. This blood is analyzed for gases in it such as O2 and CO.

Another method is blood test that is conducted mainly by nurses by taking blood vessels from a vessel and could be done more often than once. The blood test benefit in figuring out any health condition and give a specific idea about patient health. The diagnostic research is Torso X-Ray, which really is a lung and heart and soul picture and is used to detect many health conditions such as liquid around the center and lungs, cracked ribs, collapsed lungs, tumor, and contamination signs. The next method is Computerized Tomography(CT) Check out, it is comparable to breasts x-ray but here patient is given a dye before the procedure. This dye makes the computer picture clear. Allergic record is very important with all the dye (Drugs information Online, 2010).

A trusted pulmonary fibrosis test is Pulmonary Function Assessments. With this test health caregivers instruct patient to employ a device called spirometer that solution lungs level and capacity. And it provides valuable information about the lung function and status, also according to the results the caregivers would determine the best treatment for the individual. Moving to much intrusive procedure which may be considered as the last solution. Bronchoscopy is an invasive method done by utilizing a tube which allows the doctor to see inside the airways and lungs. It has a diagnostic and therapeutics uses, such as for identifying the infected area or even to remove foreign systems. To minimize pain and relax patient, medication is given before the treatment. Finally, Lung Biopsy is a test done to talk a tissue test from lungs and also to be send for further analysis. After anesthesia the doctor inserts a needle in a small incision and obtains an example (Smeltzer, Bare, Hinkle, & Cheever, 2008).

Concerning O. A he underwent many tests like Chest X-Ray which revealed visible pulmonary vasculature with bilateral basal haziness. Appearance suggestive of pulmonary congestion. Another test was done is Adult Echocardiography that proved dynamic Left Ventricle contractility and severe PAH. Furthermore, he had Head CT that illustrated minor flax calcifications at the vertex. And a tiny retention in the kept part of the sphenoid sinus. Also O. A possessed been through for Thorax CT, which established bronchieetatic changes in both lungs, more at the bases and even in the centre lobe. Honeycomb changes in both lungs, more advanced at the bottom of both lungs indicating intensive lung fibrosis.

Treatment

As mentioned earlier Idiopathic pulmonary fibrosis is a fatal disease, which has no cure until this day. Any treatment program or intervention achieved by caregivers is directed to slow the condition process and deal with the symptoms. Patient may put into action a collection of procedure to enhance the quality of life with IPF. The treatment options are: first of all, medication such as steroids to take care of the swelling and Immunosuppressant to curb the disease fighting capability and mostly combined with steroids to maximize therapeutic effect. Second, surgery that will be the last solution if no improvement observed and severe PF. Surgery can either by detatching a small infected part of lungs or by detatching the lung and replacing it with a matches healthy ( lung transplant ) (Drugs information Online, 2010).

Moreover, the procedure approaches that aim to improve patient quality of life are: pulmonary treatment and Oxygen remedy. Those treatment strategies need a collaborative healthcare team; they improve patient saturation level, prevent some problems, better breathing, and improve daily function (mayo clinic staff, 2009).

An ounce of prevention is worth one thousand treatments. Nurses should give preventive advises for patient at high dangers. Regarding to Educating Instead of Medicating (2010) pulmonary fibrosis prevention include special diet which contain Foods That Heal, Vegetable juices, Fats that Heal, Unrefined Sea Salt. Additionally, body detoxification is vital in order to get healthy kidneys, bowel, dental, and liver, which eventually promote the entire health and reduces the chance for having PF. Balanced and regular Physical Activity and Psycho-physical activity assists with improving health position. It has a mysterious impact on the Subconscious health by minimizing stress and distraction result. Examples of these activities are walking in the nature, yoga, dance, and fishing. As well as the precautionary advice is sweating. It upgraded a great cleaning results and body balance rebuilding by eliminating toxics.

Health campaign and Nursing intervention

Health promotion defined as "the activities that assist people in developing resources that maintain or enhance wellness and enhance their standard of living"(Smeltzer, Bare, Hinkle, & Cheever, 2008). As the community nurse it is part in our work and moral responsibility to promote patient health, prevent disease, and advocate for patient passions. For that people try our better to gratify patients and help them adjust with the new condition.

A Comprehensive medical care plan for an individual with Idiopathic pulmonary fibrosis includes: Advanced service planning starts with discussing patient condition, prognosis, expectation, and death. By conversing with patient truthfully, the city nurse, patient, and patient family can identify their goals and work as a team. Then, Cognitive behavioral remedy proved that it is a very essential component of the care and attention plan, as it exhibited a considerably change in patient mental status and behavior. In addition, it lowered patient stress level and depression. Lastly, pulmonary treatment programs can be implemented effectively after insuring the patient willingness to stick to those programs. They give attention to the management of symptoms such as dyspnea, upper body pain, and hypoxia (Lindell, 2007).

The nursing intervention regarding O. A pulmonary fibrosis symptoms consist of agreed goal, putting into action and educating techniques about patient needs. Starting with dyspnea, the target here is to enhance respiration. Nurse should position patient in high fowler's position if it's a gentle dyspnea and to administer oxygen in severe conditions, also it is important to teach patient about placing, triggers, and relief measures. The next thing to manage is coughing also is monitored as dyspnea concerning the education needs, however the cough is maintained by using cough suppressant after identifying the cause with caution. In case the triggering cause is smoking, the patient and the family should be educated about smoking cessation. Finally, breasts pain may be monitored by reducing stress and using medication such as analgesic and Non Steroidal Anti-inflammatory drugs (Smeltzer, Bare, Hinkle, & Cheever, 2008).

In conclusion, Idiopathic pulmonary fibrosis is a severe untreated disease that impairs patient life. There are few epidemiology studies about PF. It could be manifested as dyspnea, torso pain, and dry out coughing. These symptoms can be dealt with and managed, unlikely the disease prognosis. Although PF has undiscovered cause, doctors were able to identify the triggering factors such as smoking, viruses, and toxins. Nowadays, diagnosing IPF is much easier than ever, thanks to Torso CT, Torso X "Ray, and Bronchoscopy. The pulmonary fibrosis can be monitored by administrating air and steroid drugs. And may be avoided by following PF diet, body cleansing, and physical and mental activities, which will improve the patient general health. Through the city nurse perspective it's important to control stress and to improve action toward the condition in PF patient.

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