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N380 Clinical Case Study Presentation: Cystic Fibrosis By

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N380 Clinical Case Study Presentation: Cystic Fibrosis By Alex, Brittany & Annette Our patient: 13 year old Male Caucasian Irish Russian descent Nursing Diagnoses ... – PowerPoint PPT presentation

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Title: N380 Clinical Case Study Presentation: Cystic Fibrosis By


1
N380 Clinical Case Study Presentation Cystic
Fibrosis
  • By Alex, Brittany Annette

2
Our patient
  • 13 year old
  • Male
  • Caucasian
  • Irish Russian descent

3
Nursing Diagnoses
  • Ineffective Airway clearance related to cystic
    fibrosis as evidenced by SOB, wheezing, and
    continuous cough
  • Impaired gas exchange RT lung infection
  • Ineffective family/patient coping related to
    stress of chronic illness as evidenced by marital
    problems (family) and depression (patient).

4
Organs Affected by Cystic Fibrosis
http//www.hgen.pitt.edu/counseling/public_health/
images/cystic-fibrosis.gif
5
Significant History
  • Cystic Fibrosis Autosomal recessive disease with
    abnormally thick, abundant mucous gland
    secretion.
  • - Chronic obstructive pulmonary disorder
  • - Chronic lung infection damages lung tissue

- Becomes restrictive lung disease from fibrosis,
lung destruction and thoracic wall changes.
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6
Significant History (Cont.)
  • Cystic Fibrosis
  • Exocrine pancreatic insufficiency
  • Mucus plugs pancreatic duct
  • Causes fibrosis of acinar glands
  • Lipase, amylase, proteases dont reach intestines
    to digest fat, protein and Vitamins ADEK
  • Islets of Langerhans also become fibrotic
  • Type I Diabetes

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43.176.9/library/healthguide/en-us/images/media/me
dical/hw/h9991413_001.jpgimgrefurlhttp//64.143.
176.9/library/healthguide/en-us/support/topic.asp
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fibrosis26gbv3D226hl3Den
7
Significant History (Cont.)
  • Depression
  • Asthma, Allergic Rhinitis, Chronic Sinusitis
  • Hiatal Hernia, GERD, Lap Nissen x2
  • Sensorineural BL Hearing Loss
  • Short Stature
  • Port Placement

8
Significant Lab Values and Diagnostic Tests
  • Blood based DNA testing for CF disease and
    carrier status
  • Prenatal Test Chorionic vilus sampling.
  • Sweat Chloride Test
  • Meconium Ileus
  • Glucose testing for DM
  • LFT, Chem 7, CBC, UA

9
Communication
  • Hearing Loss
  • Poor family communication

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2hlensa2
http//www.absolutehearing.com.au/images/ear.jpg
10
Socio-economicHealth Care Barriers
  • Transportation and visiting costs
  • Moving for employment
  • Child Protective Services

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Moving20house.jpg
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car-trouble-solutions.jpg
11
Spiritual Factors
  • Catholic
  • Chaplain
  • Observes Religious Traditions
  • Prayer

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spiritual
12
Medications
  • Q-10 Co-enzyme, Vitamin D
  • Megace
  • Pulmozyme neb
  • Ultrase MT-20 Pancrelipase
  • Cipro Tobramycin
  • Meropenem
  • Aztreonem
  • Zithromax
  • Prozac
  • Somatropin
  • HGH
  • Nexium
  • Albuterol
  • Zyrtec
  • Singulair
  • Novolog
  • Lantus
  • Prednisone
  • Benadryl
  • Motrin

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agedcaremelbourne.com.au/images/care/755993_176704
80.jpgimgrefurlhttp//www.agedcaremelbourne.com.
au/care.phpusg__qvXiMeR3_A7MRksbtThFIu4_YZkh1
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42Mtbnh109tbnw150prev/images3Fq3Dmedicati
ons26gbv3D226hl3Den
13
Treatments
Physiotherapy
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cfgenetherapy.org.uk/images/phyisiotherapy.jpgimg
refurlhttp//www.cfgenetherapy.org.uk/cysticfibro
sis.htmusg__kTrbjf50Gm73G4E2c6i27Gsp39Ih1258
w1280sz52hlenstart149tbnid33u--E3BZIRJxM
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rosis26gbv3D226ndsp3D2026hl3Den26sa3DN26s
tart3D140
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mb/5/51/CFtreatmentvest2.JPG/250px-CFtreatmentvest
2.JPG
14
Ethical Considerations
  • Median survival 35 years
  • 5 of 7 siblings also have CF

15
Developmental Level
  • Language Cognitive Doing well in school despite
    frequent absences. Very mature.
  • Physical Short stature, small muscle mass.
  • Fine Motor Video games, coordinated.
  • Gross Motor Tires easily
  • Personal Social Isolated from peers, relocation,
    wants to live with mother.

16
Play and Activities
  • Needs more physical exercise
  • Video games
  • TV
  • Lack of time with peers due to continuous
    grounding

http//images.google.com/imgres?imgurlhttp//urbn
ews.tv/wp-content/uploads/2008/03/bg_kid.gifimgre
furlhttp//urbnews.tv/3Fp3D98usg__DZXYg8gmYPN
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tbnid7j8H7nbuzHdSSMtbnh126tbnw58prev/image
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sa2
17
Plan of Care
  • Lung health
  • Breathing treatments/Respiratory Stats
  • Exercise
  • Glucose monitoring
  • Nutrition and Hydration
  • Therapeutic conversation

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nursingplanaqfoq
18
Patient Family Teaching
  • Facilitate Interfamily communication
  • Nutrition for CF IDDM
  • Exercise
  • Support Groups

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communicationaqfoq
19
Journal References
  • Title The Flutter Device versus the PEP Mask in
    the Treatment of Adults with Cystic Fibrosis
  • Purpose Compare effectiveness of flutter device
    to the Pep Mask in treating CF
  • Sample 42 adults with CF
  • Method
  • Adults were randomly assigned one of the
    treatments
  • Pulmonary function test, Quality of Wellbeing
    Scale, and Chronic Respiratory Disease
    Questionnaire were administered every 3 months,
    to measure effectiveness of treatment on adult
  • Results There was no significant difference in
    pulmonary function or health-related QoL

20
References
  • Newbold, E., Tullis, E., Corey, M., Ross, B.,
    Brooks, D. (2005).The Flutter Device versus the
    PEP Mask in the Treatment of Adults with Cystic
    Fibrosis. Physiotherapy Canada. 57, 199-206.
  • Swisher, A., Erickson, M. (2008, December).
    Perceptions of physical activity in a group of
    adolescents with cystic fibrosis. Cardiopulmonary
    Physical Therapy Journal, 19(4), 107-113.
    Retrieved April 23, 2009, from CINAHL with Full
    Text database.
  • Wilkinson, J. M. (2005). Nursing Diagnosis
    Handbook (Eighth ed.). Upper Saddle River, New
    Jersey Pearson Prentice Hall.
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