Chronic Bronchitis
Chronic bronchitis is a disorder that causes inflammation to the airway, mainly the bronchial tubules. It produces a chronic cough that lasts three consecutive months for more than two successive years (Vijayan,2013). Chronic Bronchitis is a member of the COPD family and is prominently seen in cigarette smokers. Other factors such as air pollutants, Asbestos, and working in coal mines contributes to inflammation. Once the irritant comes in contact with the mucosa of the bronchi it alters the composition causing hyperplasia of the glands and producing excessive sputum (Viayan,2013). Goblet cells also enlarge to contribute to the excessive secretion of sputum. This effects the cilia that carry out the mechanism of trapping foreign bodies to allow it to be expelled in the sputum, which are now damaged by the irritant making it impossible for the person to clear their airway. Since the mechanism of airway clearance is ineffective, the secretion builds up a thickened wall of the bronchioles causing constriction and increasing the work of breathing. The excessive build up of mucous could set up pneumonia. The alveoli are also damaged enabling the macrophages to eliminate bacteria putting the patient at risk for acquiring an infection.
The clinical manifestation one may see in patients with chronic bronchitis are chronic cough, weight loss, excessive sputum, and dyspnea. Chronic cough is from the body trying to expel the excessive mucus build up to return breathing back to normal. Dyspnea is from the thickening of the bronchial walls causing constriction, thereby altering the breathing pattern. This causes the body to use other surrounding muscles to help with breathing which can be exhausting. These patients ca...
... middle of paper ...
...ering to medication antibiotics which fight off infections, bronchodialators used to decrease dyspnea relieve broncho spasms , and pulmonary rehabilitation help betters their condition. The nurse expects the patient to be able to perform suitable activities without complication, avoid irritants that can worsen the disease (contaminated air) and reduce pulmonary infection by abiding to medications.
References
Vijayan, V. K. (2013). Chronic obstructive pulmonary disease. Indian Journal Of Medical Research, 137(2), 251-269.
Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
The presented case is of a patient named R.S. who has a smoking history of many years, which can be directly tied to his development of chronic bronchitis, a chronic obstructive pulmonary disease (COPD) specified as Type B. It is estimated that in 90% of chronic bronchitis or “blue bloaters”, cigarette smoking is the major cause. Chronic bronchitis involves persistent and irreversible airway obstruction, due to the constant inflammation of the bronchial mucosa, leading to hypertrophy and hyperplasia of bronchial glands. The latter exposes the individual to higher risks of bacterial infections; often colonization of organisms such as Streptococcus or Staphyloccocus pneumoniae can be exhibited. This is due to the lost or impaired function of mucociliary clearance action which results from the replacement of certain sections of ciliated columnar epithelium by squamous cells in the bronchi. (Copstead &Banasik, 546-547)
It incorporates dietary advising, exercise training, and mental guiding. There are also numerous surgical treatment alternatives. For example, the removal of nasal polyps that block breathing, oxygen treatment to prevent pulmonary hypertension, endoscopy and lavage to suction mucus from airways, the surgical insertion of a feeding tube may be important to convey supplements while sleeping. In cases where life-threatening lung complexities arise, a lung transplant may be viewed as an option.
Mrs. Jones has a history of COPD. She was already taking albuterol for her illness and it was ineffective when she took it that day. Mrs. Jones had been a smoker but had quit several years ago. According to Chojnowski (2003), smoking is a major causative factor in the development of COPD. Mrs. Jones's primary provider stated that she had a mixed type of COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) was established to address the growing problem of COPD. The GOLD standards identify three conditions that contribute to the structural changes found in COPD: Chronic bronchiolitis, emphysema, and chronic bronchitis. A mixed diagnosis means that the patient has a combination of these conditions (D., Chojnowski, 2003). Mrs. Jones chronically displayed the characteristic symptoms of COPD. "The characteristic symptoms are cough, sputum production, dyspnea on exertion, and decreased exercise tolerance." (D., Chojnowski, 2003, p. 27).
Chronic obstructive pulmonary disease, better known as COPD, is a disease that affects a person’s ability to breathe normal. COPD is a combination of two major lung diseases: emphysema and chronic bronchitis. Bronchitis affects the bronchioles and emphysema affects the alveoli.
Oxygen, inhaled bronchodilators, inhaled steroids, combination inhalers, oral steroids, phosphodiesterase-4 inhibitors and theophylline are effective medications for COPD (Mayo Clinic, 2016). “Patients with COPD have persistent high levels of CO2, their respiratory centers no longer respond to increased levels of CO2 by stimulating breathing. Therefore, COPD patients with more severe hypoxemia are at higher risk of CO2 retention from uncontrolled CO2 administration” (Van Houten, p. 13). For nurses, “It is important to administer the lowest amount of O2 necessary to patients” (Van Houten, p. 13). Some COPD medicines are used with inhaler and nebulizer devices. It is important to teach patients how to use these devices correctly. (Potter & Perry,
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
Carone M, D. C. ( 2007). Clinical Challenges In COPD[e-book]. (Oxford: Clinical Pub) Retrieved March 24, 2014, from (EBSCOhost).
Works Cited Ackley, B. & Ladwig, G. (2010) Nursing diagnosis handbook: an evidence-based guide to planning care. Maryland Heights, MO: Mosbey, MO. Ignatavicius, D. D., & Workman, M. L. (2013). Care of Intraoperative Patients.
One of the common diseases in the respiratory system that many people around the world face is emphysema or also known as chronic obstructive pulmonary disease (COPD). It is a chronic lung condition where the alveoli or air sacs may be damaged or enlarged resulting in short of breath (Mayo Clinic, 2011). If emphysema is left untreated, it will worsen causing the sphere shaped air sacs to come together making holes and reduce the surface area of the lungs and the amount of oxygen that travels through the bloodstream, blocking the airways of the lungs (Karriem- Norwood, 2012). The most common ways a patient can get emphysema are by cigarette smoking or being exposed to chemicals, dust or air pollutants for a long period of time. Common physical exams reveal a temperature of 100.8 Fahrenheit, 104 beats per minute, a blood pressure of 146/92, and a respiratory rate of 36 breaths per min (Karriem- Norwood, 2012). (see appendix A.1,A.2, A.3, A.4 for complete proof.)
In summary, the paper focused on caring for an infant with bronchiolitis. The student nurse has realised that it is important to gather information from the parents because they know their baby best. Nursing interventions should encourage family members to participate as well as they are the one who care about their child most. Special attention need to pay for children who attend day-care facility and follow up care is necessary.
Chronic Obstructive Pulmonary Disease (COPD) is a lung disease that affects breathing. This disease is one that blocks or obstructs air flow which then affects the way that one breathes. It diminishes the capability of airflow in and out of the lungs. COPD is the term used for a group of different diseases that affect the lungs. The two most common types of COPD are emphysema and chronic bronchitis. Emphysema is a destruction of the small bronchioles in the lungs and chronic bronchitis is an inflammation of the lining of the bronchial tubes. Both emphysema and chronic bronchitis are obstructive diseases that impact breathing in a negative manner. (COPD, 2014)
Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992). The diagnosis of COPD is predominantly based on the results of a lung function assessment (Larsson, 2007). Chronic bronchitis is differentiated from emphysema by it's presentation of a productive cough present for a minimum of three months in two consecutive years that cannot be attributed to other pulmonary or cardiac causes (Marx, Hockberger & Walls, 2014) (Viegi et al., 2007). Whereas emphysema is defined pathologically as as the irreversible destruction without obvious fibrosis of the lung alveoli (Marx, Hockberger & Walls, 2014) (Veigi et al., 2007).It is common for emphysema and chronic bronchitis to be diagnosed concurrently owing to the similarities between the diseases (Marx, Hockberger & Walls, 2014).
Parker, Steve. "Chronic Pulmonary Diseases." The Human Body Book. New ed. New York: DK Pub., 2007.
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
Potter, P. A., & Perry, A. G. (2009). Fundamentals of nursing (Seventh ed.). St. Louis, Mo.: Mosby Elsevier.