Pulmonary fibrosis Flashcards
(17 cards)
What is pulmonary fibrosis?
Pulmonary fibrosis is a chronic and progressive interstitial lung disease characterized by scarring (fibrosis) of lung tissue, which causes the lungs to become stiff and limits their ability to expand and contract.
Describe the pathophysiology of pulmonary fibrosis?
In response to injury, the lung tissue becomes damaged and instead of healing normally, fibrous tissue forms, the normal repair process is disrupted, leading to excessive deposition of fibrotic tissue.
The scarring thickens the tissue between the alveoli (air sacs), making it difficult for oxygen to pass into the bloodstream, leading to shortness of breath and reduced oxygen levels in the body.
Over time, this leads to decreased lung compliance, impaired gas exchange, and progressive dyspnea.
What are pulmonary fibrosis Examples?
Idiopathic Pulmonary Fibrosis (IPF) exact cause unknown.
Fibrosis caused by radiation therapy
Drug-induced fibrosis (e.g., from chemotherapy or amiodarone)
Fibrosis from autoimmune diseases (e.g., rheumatoid arthritis)
What are the risk factors and causes of pulmonary fibrosis?
Age (more common in people over 60)
Smoking history
Long term occupational and Exposure to environmental pollutants (e.g., asbestos, dust)
Radiation therapy to the chest such as for lung and breast cancer.
Use of certain medications (e.g., chemotherapy, and heart medications e.g. amiodarone)
Autoimmune diseases (e.g., scleroderma, lupus)
Family history of pulmonary fibrosis
What are the symptoms of pulmonary fibrosis?
Progressive shortness of breath (dyspnea), especially during exertion like physical activities, Chronic dry cough, Fatigue, Clubbing (widening and rounding) of fingers or toes, Unexplained weight loss and muscle aches, Chest discomfort or pain.
How do you detect pulmonary embolism, or how does PE clinically present in a patient?
Gradual onset of breathlessness
Dry cough not linked to infection
Fine inspiratory crackles on auscultation (velcro-like)
Hypoxemia during physical activity
How do you assess pulmonary embolism in a patient?
Respiratory rate and effort
Oxygen saturation (SpO2)
Breath sounds (fine crackles)
History of risk exposures (occupational, environmental, medication)
What tests or diagnostic approaches can be made to determine pulmonary fibrosis?
High-Resolution CT (HRCT) scan: Gold standard for visualizing fibrosis. It provides detailed images of lung tissue and can identify the characteristic patterns of fibrosis.
Chest X-ray: May show reticular markings or honeycombing? may show changes in lung structure, but it is less sensitive than a CT scan for early disease.
Lung function tests: Reduced forced vital capacity (FVC), Reduced DLCO (diffusing capacity for carbon monoxide) Evaluates how well gases pass from the lungs into the bloodstream; often reduced in pulmonary fibrosis.
Lung biopsy: Sometimes needed to confirm diagnosis if imaging results are inconclusive.
Blood tests to identify autoimmune causes
What are the emergency responses or first aid for pulmonary fibrosis?
Administer high-flow oxygen for acute respiratory distress
Position patient upright to ease breathing
Monitor vital signs and SpO2
Alert emergency services or transport to hospital
Reassure and calm the patient
What are the pharmacological treatments for pulmonary fibrosis?
Antifibrotic medications: can help slow the progression of idiopathic pulmonary fibrosis (IPF) by reducing fibrosis. Pirfenidone, Nintedanib.
Corticosteroids and immunosuppressants in autoimmune-related fibrosis
Oxygen therapy to improve oxygen saturation especially during physical activity or sleep.
What are the non pharmacological treatments for pulmonary fibrosis?
Pulmonary rehabilitation: exercise, breathing techniques, education, Nutritional support, Lung transplant (in severe or end-stage cases)
What are the complications of pulmonary fibrosis?
Respiratory failure, Pulmonary hypertension, Heart failure (right-sided), Pneumonia, Lung cancer (rare but increased risk)
What diseases or organ complications can lead to pulmonary fibrosis?
Connective tissue diseases (e.g., RA, scleroderma), Chronic hypersensitivity pneumonitis, Sarcoidosis, Tuberculosis or untreated infections
What nursing assessments can be done to care/ to create a thorough care plan for a patient with pulmonary fibrosis?
Monitor vital signs such as respiratory rate, oxygen saturation, breath sounds
Evaluate exercise tolerance and fatigue level
What nursing interventions and treatments can be done to care/ to create a thorough care plan for a patient with pulmonary fibrosis?
Administer medications and oxygen as prescribed
Encourage participation in pulmonary rehab
Provide emotional support and coping strategies
Educate on energy conservation techniques
Assist with mobility and ADLs as needed
Watch for medication side effects, particularly from antifibrotic drugs.
What nursing preventions can be done to care/ to create a thorough care plan for a patient with pulmonary fibrosis?
Avoid exposure to lung irritants (smoke, pollutants)
Early treatment of respiratory infections
Vaccinations (influenza, pneumococcal)
Describe the patient education and self-monitoring/ self-care guidelines that can be given to a patient with pulmonary fibrosis?
Adherence to prescribed medications (e.g., antifibrotics)
Use oxygen therapy as directed
Recognize signs of worsening (increased dyspnea, fatigue)
Attend regular check-ups and pulmonary rehab
Maintain a healthy lifestyle: nutrition, hydration, low-sodium diet
Avoid exposure to respiratory irritants such as smoke and pollution.
Plan for advanced care if disease progresses
