Nursing diagnoses describe problems that can be addressed by nursing measures. Because nurses can't diagnose a disease or prescribe medication, a nursing diagnosis doesn't describe a disease or prescribe medications or treatments beyond a nurse's scope of practice. In the case of a disease like cystic fibrosis, nursing diagnoses center on treating problems caused by the disease. Description
According to the North American Nursing Diagnosis Association, or NANDA, there are five possible categories for a nursing diagnosis: an actual problem, possible problem, risk, syndrome or wellness. Cystic fibrosis causes lung damages from thickened secretions. A risk-related nursing diagnosis for cystic fibrosis would describe interventions that address complications from the disease. For example, recurrent lung infections are a symptom of cystic fibrosis, so "Risk for infection related to chronic pulmonary disease" would be a typical diagnosis.
Purpose The purpose of a nursing diagnosis is to establish actions that can be carried out by everyone caring for a patient so that certain goals can be achieved. NANDA emphasizes that nursing diagnoses should be modified as necessary and should always be related to an individual patient's needs, rather than being generalized for all patients with the same disease process. Assessment
A nursing diagnosis includes assessments that are done to determine a problem. In the case of the diagnosis "Risk of infection related to chronic pulmonary disease," assessment might include checking lung sounds, taking oral temperatures or monitoring a patient's color for signs of decreased oxygenation. Interventions
Every nursing diagnosis lists interventions that help achieve the goal. In the case of "Risk of infection related to chronic pulmonary disease," interventions to reduce the risk are spelled out. Examples of interventions might include oral antibiotics, adequate fluids and administering aerosol treatments as ordered by the physician, according to the Mayo Clinic. Interventions must be specifically geared to the patient's needs, listing a time frame and the exact action to be performed. Expected Outcomes
Expected outcomes for a nursing diagnosis are the intended goals. In the case of a care plan for risk of infection, the expected outcome could be that the patient is free from infection as evidenced by clear lungs, no fever and no complaints of chest pain for the next 24 hours.
Evaluation An evaluation is done after the intervention required by the nursing diagnosis to see whether the stated goals have been met. If the stated goals aren't met, the evaluation may describe new interventions to improve the chance of meeting the goals. In the case of infection risk, an evaluation might state that the patient's lungs are not clear after aerosol treatment and might mention the need to inform the physician.
Health Screening, health promotion, interventions with this childhood condition There are several kinds of inhaled medications used to treat CF symptoms: * Mucolytics like Pulmozyme to thin mucus so people can cough it out easier. * Antibiotics to treat infections. Inhaled TOBI (tobramycin solution for inhalation) is a widely used antibiotic treatment. TOBI can be effective against the most common source of chronic lung infections, a bacterium called Pseudomonas aeruginosa. * Hypertonic saline to draw more water into the airways and make it easier to cough out the mucus. Antibiotics
Antibiotics are used to fight infection-causing bacteria. Infections are common in the lungs of people with cystic fibrosis, so antibiotics are an important part of regular care. Other treatments:
The first drug that treats an underlying cause of cystic fibrosis, rather than just the symptoms, was approved by the Food and Drug Association, more than 22 years after the gene responsible for the disease was first identified. The medicine called Kalydeco. It's designed to treat people with a lung disease called cystic fibrosis. While not quite a cure, the drug is extremely effective for some CF patients. The drug, called Kalydeco and developed by Vertex Pharmaceuticals, counters the effect of one specific mutation in the gene that accounts for 4 percent — or about 1,200 — cystic fibrosis cases in the United States.
Nutrition & Eating Right Nutrition needs change with age — especially for people with cystic fibrosis. Dietitians at cystic fibrosis care centers offer specially tailored dietary programs for each stage of life. Children and teens with cystic fibrosis need extra calories to grow and develop. Everyone with CF, no matter their age, need good nutrition to stay strong against lung infections and other challenges. Occasionally, patients need to take nutrition through a tube ("tube-feeding") to provide extra calories that help the body grow and stay strong. Almost half of all people with cystic fibrosis in the United States today are adults. They are facing diseases most often associated with the middle-aged or elderly. These diseases include CF-related diabetes and brittle bones (osteoporosis). By working closely with CF care centers, good nutrition can help to prevent or lessen the impact of these and other health problems. Alternative Therapies
Over the years, some research have indicated that people can gain health benefits by increasing their intake of antioxidants, either by eating more fruit and vegetables or by taking supplements. Healthy, non-cystic fibrosis lungs appear to have more natural antioxidants than cystic fibrosis lungs. The lack of natural antioxidants is considered by researchers to be a possible factor in the inflammation and infection cycle in CF. Resources for Cystic Fibrosis nationally and locally
The Cystic Fibrosis Institute (CFI) is committed to supporting those affected by cystic fibrosis in the Chicagoland area and to making a difference by being a meaningful and active source of assistance and advocacy for all CF individuals and families for dealing with the everyday challenge of cystic fibrosis. Their website is [email protected] and their contact number is 847-998-3434. There also is the Cystic Fibrosis Foundation that will assist you in finding a local chapter.