Nursing care and patient education

- The nursing care of patients with CF focuses on providing holistic care that addresses the physical, emotional, social, and spiritual needs of the patient and the family.

- The nursing care plan may include the following:

• Assessing the patient's respiratory status, including breath sounds, respiratory rate, oxygen saturation, sputum production, cough, dyspnea, chest pain, and signs of infection or exacerbation.
• Administering medications as prescribed and monitoring their effects and side effects.
• Assisting with chest physiotherapy and airway clearance devices as ordered and teaching the patient and the family how to perform them correctly and safely at home.
• Providing oxygen therapy as ordered and monitoring its effects and complications.
• Encouraging fluid intake to hydrate the mucus membranes and thin the secretions.
• Providing a high-calorie, high-protein diet that is supplemented with vitamins A, D, E, K, and pancreatic enzymes to prevent malnutrition and malabsorption.
• Monitoring the patient's weight, height, body mass index (BMI), and growth charts regularly.
• Assessing the patient's gastrointestinal status, including bowel sounds, abdominal pain, distension, nausea, vomiting, diarrhea, constipation, and signs of intestinal obstruction or perforation.
• Administering laxatives, stool softeners, or enemas as needed to prevent or relieve constipation.
• Assessing the patient's skin integrity, especially in areas prone to pressure ulcers, such as sacrum, heels, and elbows.
• Applying moisturizers, barrier creams, or dressings as needed to prevent or treat skin breakdown.
• Assessing the patient's psychosocial status, including mood, coping skills, self-esteem, body image, social support, and quality of life.
• Providing emotional support and counseling to the patient and the family and referring them to appropriate resources such as support groups, social workers, psychologists, or chaplains as needed.
• Educating the patient and the family about CF and its management and treatment options.
• Teaching them how to recognize and report signs and symptoms of complications or worsening condition such as fever, increased sputum production, change in sputum color or consistency, hemoptysis, increased dyspnea, chest pain, cyanosis, clubbing, weight loss, anorexia, jaundice, ascites, edema, or bleeding.
• Teaching them how to prevent and control infections by practicing good hand hygiene, avoiding contact with sick people, getting vaccinated, and taking prophylactic antibiotics as prescribed.
• Teaching them how to adhere to the medication regimen and the importance of taking the medications as prescribed and not skipping or altering doses without consulting the health care provider.
• Teaching them how to use and care for the inhalers, nebulizers, airway clearance devices, oxygen equipment, and other devices as prescribed.
• Teaching them how to monitor and record their vital signs, oxygen saturation, peak expiratory flow rate (PEFR), sputum characteristics, weight, and dietary intake at home.
• Teaching them how to plan and modify their daily activities according to their energy level and tolerance and how to balance rest and exercise.
• Teaching them how to cope with stress and anxiety by using relaxation techniques, distraction methods, positive thinking, or humor.
• Teaching them how to maintain a positive outlook and a hopeful attitude toward the future.