BRONCHIECTASIS and their causes, symptoms

BRONCHIECTASIS and their causes, symptoms

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  Click to editMaster subtitle style 4/29/12 BRONCHIECTASIS By, RAIZA RAJU
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  4/29/12 anatomy
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  4/29/12 Definition Bronchiectasis is achronic, irreversible dilation of the bronchi, and bronchioles. Under the new definition of COPD, it is considered a disease process separate from COPD.
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  4/29/12 etiology *Airway obstruction *Infectious agents Adenovirus Influenzavirus Staphylococcus aureus Klebsiella Anaerobics M.Avium *Diffuse airway injury *Pulmonary infections and obstruction of bronchus
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  4/29/12 Pathophysiology PREDISPOSING FACTORS •Respiratory infections inchildhood. •Measles. •TB •Influenza CAUSAL FACTORS *Airway obstruction •Diffuse airway injury. • Pulmonary infections. • Genetic disorder. Inflammatory process
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  4/29/12 Damages bronchial wall Lossof supporting structures Thick sputum production Permanent distension and distortion of bronchial walls, impaired mucociliary clearance
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  4/29/12 Saccular bronchiectasis Cylindric bronchiectasis
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  4/29/12 Clinical manifestations Ø Productivecough - recurrent, paroxysmal,>20 ml sputum per day, stimulated with position changes. Ø Exertional dyspnea. Ø Fatigue. Ø Weight loss. Ø Anorexia. Ø Fetid breath. Ø Any combination of crackles, rhonchi and wheezing Ø Sinusitis. Ø Hemoptysis.
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  4/29/12 Diagnostic measures Ø Historyand Physical examination Ø Chest x-ray.
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  4/29/12 Ø High resolutionCT scan Ø Bronchoscopy Ø Sputum examination Ø Pulmonary function studies
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  4/29/12 MANAGEMENT
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  4/29/12 MEDICAL MANAGEMENT Ø Posturaldrainage.
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  4/29/12 Ø Chest physiotherapy. ØMaintain good hydration. Ø Reduce exposure to excessive air pollutants. Ø Avoid cigarette smoking. Ø Positive Expiratory Pressure(PEP) - breathing maneuver against on expiratory resistance.
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  4/29/12 Pharmacological management Ø Antibioticsbased on sputum production. Ø Antipseudomonal antibiotics. eg: Nebcin. Ø Bronchodilators.
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  4/29/12 Surgical management v Surgicalresection of an affected lobe. v Lung transplantation.
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  4/29/12 NURSING DIAGNOSIS  Ineffectiveairway clearance related to expiratory airflow obstruction as manifested by abnormal breath sounds.  Ineffective breathing pattern related to increased mucus production as manifested by shortness of breath.  Self care deficits related to fatigue secondary to increased work of breathing and insufficient ventilation as manifested by inability to do ADL to full extend. Activity intolerance due to fatigue, hypoxemia as manifested by difficulty with ADL.
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  4/29/12 bibliography  Lewis M.S,Heitkemper M.M, Dirksen R.S(2004), Medical Surgical Nursing, Assessment and Management of Clinical Problems, 6th Edition, Mosby(P), USA.  Smeltzer C.S, Bare G.B, Hinkle L.J et.al(2004), Brunner and Suddarth’s Textbook of Medical Surgical Nursing, Volume 1,12th Edition, Lippincott(P), India.