Interstitial lung diseases 2: management strategies

This is the second part of a two-part unit on interstitial lung diseases (ILDs). Part 1 examined the challenges of diagnosis and the range of investigations. This part explores management strategies for the three most common ILDs.

Benign lymphoproliferative disorders

OBJECTIVE

To provide a review of three benign lymphoproliferative disorders commonly encountered in nursing practice: (1) infectious mononucleosis, (2) cat scratch disease, and (3) sarcoidosis.

DATA SOURCES

Research studies, review articles, and book chapters pertaining to benign lymphoproliferative disorders.

CONCLUSIONS

Benign lymphoproliferative disorders may be associated with infections, autoimmune disorders, hypersensitivity reactions, and unknown causes. Most of these disorders are self-limiting; however, some are associated with significant morbidity and mortality.

IMPLICATIONS FOR NURSING PRACTICE

Benign as well as malignant lymphoproliferative disorders will be encountered with increasing frequency by nurses in ambulatory settings. Nurses need to have a basic knowledge of these disorders that present a diagnostic and management challenge.

The Transition From Victim to Victor: Application of the Theory of Mastery

1. Serious, chronic disease, such as sarcoidosis, evokes life-changes that may require mastering stress, recovering self-esteem and finding alternative sources of satisfaction for what is lost. 2. The theory of mastery offers patients and nurses an explanation of how to emerge ever stronger and more resilient in dealing with the self and the environment. 3. Over time, four stages of the theory of mastery may be encountered: certainty, change, acceptance, and growth. Nurses may assist patients to see how they may "master" each stage to achieve personal growth, hence a greater quality of life.

Helping Them Cope: Developing self-help groups for clients with chronic illness

1. Self-help groups for individuals with sarcoidosis (a noncontagious multisystem disorder characterized by granulomas in many organs) are rare despite the physical and emotional problems associated with this disease. 2. The stimulus for the development of the group arose when staff in a pulmonary clinic identified that sarcoidosis patients were helping each other cope with problems and concerns related to their disease and feelings of isolation. 3. Nurses play a significant role in creating vehicles of help and service to facilitate and support patients experiencing fear and anxiety about their disease. Nurses must recognize the role self-help groups play in assisting individuals to maintain their quality of life as they adapt to the psychosocial, physiological, and medical aspects of their illness.