Hi. I'm Cathy with Level Up RN. In this video, we are going to talk about interstitial lung disease
as well as pulmonary hypertension. And at the end of the video, I'm going to give you guys a quick
little quiz to test your knowledge of some of the key facts I will be covering in this video.
So interstitial lung disease is really an umbrella term used for a group of restrictive
lung disorders that cause stiff and non-compliant lungs. So when we talked about asthma, COPD
and cystic fibrosis, those are obstructive lung diseases. So the primary issue with obstructive
lung diseases is the inability to exhale completely, get the air out of the lungs. With
restrictive lung disorders, such as interstitial lung disease,
we have issues getting air into the lungs because of those stiff and non-compliant lungs.
So the pathophysiology behind this condition is that we have chronic inflammation of
the lungs that causes the replacement of healthy lung tissue with fibrotic scar tissue.
Risk factors associated with this disorder include environmental inhalants like asbestos,
immune dysfunction, and then something called sarcoidosis, which is an auto-immune disorder
that causes the formation of these nodules in the lungs. In terms of the signs and symptoms
of interstitial lung disease, your patient may have a cough, they may have dyspnea,
so difficulty breathing, chest discomfort, fatigue, and clubbing. So clubbing,
if you don't remember, is kind of the enlargement of the fingertips with spoon-shaped fingernails,
so kind of rounded, upside-down spoons. In terms of diagnosis, we can use pulmonary
function tests, a chest X ray, and a lung biopsy to help diagnose this group of disorders. In terms
of treatment, oxygen therapy can be used. We can also give the patient anti-inflammatories
such as corticosteroids, and then long term, a lung transplant may be necessary.
Now, let's talk about pulmonary hypertension. And as the name suggests, we have hypertension,
so high blood pressure in the lungs. And this is due to narrowing of the arteries in the lungs
and increased vascular resistance. So if you think about the blood flow through the heart,
we have blood coming in to the right atrium and then the right ventricle and then to the lungs.
And if we have this increased resistance in the lungs, then that blood is going to back
up into the right ventricle and cause enlargement of that right ventricle.
So this is something called cor pulmonale. It's a key complication with pulmonary hypertension.
In terms of the risk factors associated with this condition, cardiac defects or disease
will be some key risk factors, as well as lung disease and a pulmonary embolism.
Symptoms may include dyspnea, so difficulty breathing, fatigue,
pallor, chest pain upon exertion, and then with that backup of blood into the right ventricle,
we may end up with right-sided heart failure, which can cause edema in the patient.
In terms of diagnosis, we can do a diagnosis of this condition using an echocardiogram, a cardiac
catheterization, and then with hemodynamics, we'll find an increase in pulmonary artery pressure.
Treatment includes diuretics to try to get rid of excess fluid, digoxin to help the
heart beat more effectively, and vasodilators. In terms of nursing care, we would administer
oxygen as ordered. We would implement fluid restriction for right-sided heart failure
if indicated. We also want to closely monitor the patient's eyes and nose, their daily weight,
and also encourage the patient to take frequent rest periods because of the
fatigue associated with pulmonary hypertension. Okay. Time for a quiz. I have two straightforward
questions for you. First question. Interstitial lung disease is an example of a restrictive or
obstructive lung disease? The answer is restrictive. Question number two.
What do you call right ventricular enlargement that occurs with pulmonary hypertension?
The answer is cor pulmonale. Hope you did well, hope this video was helpful, and I'll see you
on another video soon. Thanks for watching. I invite you to subscribe to our channel and share
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