Restrictive Lung Diseases
Interstital lung disease
Diffuse parenchymal lung disease (DPLD)
Disease presentation
The patient with DPLD often presents with chronic progressive dyspnea on exertion and a cough which is often non-productive. The patient should be closely examined for symptoms of underlying connective tissue disease such as joint pains, erythema and swelling of the joints of the hands, which is indicative of rheumatoid arthritis, and which may or may not have been previously diagnosed.
Interstitial Lung Disease
Complex lung disorder
Nursing care for interstitial lung disease
1. Monitoring
Of response to treatment and also for side-effects of medication. Azathioproine and other cytotoxic treatments will require regular blood tests to monitor renal function.
2. Symptom control especially for cough and breathlessness:
. Cough may be treated with codeine, or pholcodine, but patients need to be aware of side-effects such as constipation · Morphine may help both breathlessness and cough in the later stages of the disease but again there are side effects.
3. Panic and anxiety
are commonplace with any lung disease that causes breathlessness. Lorazepam 0.5mg used sublingually (unlicensed use in UK) may dissipate the effects of anxiety and is rapidly absorbed by the mucous membranes
4. Oxygen therapy
Hypoxemia and type 1 respiratory failure may mean oxygen is necessary. Patients with DPLD typically do not retain carbon dioxide and therefore can tolerate high flow rates which may be necessary as the condition deteriorates. Oxygen saturations should be monitored regularly, and changes of flow rates made appropriately
