Pulmonary fibrosis/problems nursing diagnosis recommendations....

[Animaniacs, BSN, RN]

Hello,

what are some good nursing diagnosis for a person who has pulmonary fibrosis or any pulmonary problems.

the pt. I had 1 week ago during clinical was diagnosed with pulmonary fibrosis and he had a Right lung thorascopic biopsy done to figure out what exactly is the problem; the patient has had Shortness of breath for the last year, lethargy and fatigue; just dressing up in the morning to get to work makes him really tired. and he has been coughing clear sputum. he is on O2 2L NC. and his shortness of breath has gotten worse to a point where he had to be hospitalized. he works at a place where he is exposed to car exhaust, fumes, and pollution in the air.

he is considering changing jobs, and he appears to have a good idea where he wants to work, a place where he isn't exposed to pollution, exhaust, chemical fumes. so he said he will probably go to college and do some sort job at a hospital, probably an xray tech or something.

the diagnosis I am going right now is Impaired Gas Exchange. and I need 4 diagnosis to do 4 careplans.

Ineffective airway clearance might be good too, but I dont see how it relates to this pt. anyways, any help is really appreciated.

[LydiaGreen]

I'm not the best at these (experienced nurses have a magical way of zipping off all of the major considerations without even thinking) but, I'll give it a shot:

Fatigue R/T impaired gas exchange blah,blah,blah - for your interventions you could use teaching the client to perform ADLs in small increments, sit on a chair at the BR sink to perform a.m. and hs care, and so on.

Change in role R/T disease process blah,blah,blah - meaning he worked at one position for x number of years and now this is adversely effecting his health, you could use your discussions with him about leaving that job as one of the interventions

One thing that I would want to look at closely would be the results of that biopsy. Fibrosis is definitely not a good thing. Any Hx of COPD? Ca? The results of the biopsy will indicate what this gentleman's real needs are.

[purplemania, BSN, RN]

have you considered any psychosocial DX related to his disease and the effect it has on his lifestyle?

[Jolie, BSN]

Your description of this patient SCREAMS out a number of problems without even having to think about them! And I'm a NICU nurse who has never laid hands on a sick adult! Trust your judgement!

Impaired gas exchange due to pulmonary fibrosis

Alteration in comfort due to shortness of breath

Activity intolerance

Potential for injury due to workplace exposure to pollutants

Potential for infection (high risk for influenza) due to chronic lung disease

[leslie :-D]

you would always address the most critical ones at hand, which evidentally is going to revolve around pt's breathing/gas exchange/ventilation.

[llg, PhD, RN]

... and let's not forget all the educational issues .... and perhaps some spiritual distress ... perhaps there are role changes within his family because of his illness ... and a host of financial problems that effect a person's well being.

llg