BRONCHIECTASIS

BRONCHIECTASIS

DEFINITION:-

It is permanent or irreversible dilation of large airway (bronchial tree) caused by destruction of muscles and elastic tissues.


TYPES:-

According to pathological conditions:


Saccular (in large bronchi).

Cylindrical (in medium size bronchi).

Fusiform.

Varicose.


CAUSES/AETIOLOGY:-

It have same cause like Pneumonia.


Bacterial

Viral

Endobronchial obstruction (tumours, foreign body, sputum etc.)

Chronic coughing and excess mucous production.


CLINICAL MANIFESTATION (SIGNS/SYMPTOMS):-

Wheezing due to collection of fluid

Copious sputum (excessive sputum)

Cyanosis (blue discolouration of skin)

Coughing

Dull and flatted sound over area of mucous cough.

Paroxysm of coughing on rising, moving, or when lying down position.

Purulent sputum

Dyspnoea

Weakness

Haemoptysis

Fatigue

Loss of appetite and weight loss.

Clubbing of finger and toes. (Nail becomes convex/change the normal angle of nail.)


DIAGNOSTIC EVALUATION:-

History collection

Chest X-ray

CT scan

Physical examination

Bronchography

Sputum examination.


COMPLICATIONS:-

Haemoptysis

COPD

Chronic respiratory failure

Pulmonary hypertension

Pneumonia

Anaemia.


PATHOPHYSIOLOGY:-

Due to pulmonary infection

↓

Inflammatory Process

↓

Resulting in thick sputum production

↓

obstruction in bronchi

↓

The wall become permanent distended and distorted

↓

obstruction in bronchi

↓

Inflammation and infection extended to peribronchial tissue

↓

Affects on lower lungs segment

↓

Lung abscess


MEDICAL MANAGEMENT:-

Administration of antibiotics on the basis of culture and sensitivity of sputum.

Administration of brochodilators and expectorants.

Provide chest Physiotherapy.


SURGICAL MANAGEMENT:-

If the medical management is unsuccessful then there is surgical management


Segmentectomy (Surgical removal of segment

Lobectomy (Surgical removal of lobe)



NURSING MANAGEMENT:-

Provide adquate rest and comfort to the patient

Provide high protein and high calorific diet to the patient

Provide good oral hygiene

Remove thick secretion

Advice patient to avoid cigratte smoking

Advice patient to avoid cold enviroment or cold exposure.

NURSING DIAGNOSIS:-

Impaired gas exchange related to decreased ventilation and mucous plugs.

Anxiety related to breathing difficulty

Altered nutrition less than body requirements related to reduced appetite, dyspnoea and decrease energy level.

Sleep pattern disturbance related to dyspnoea and external stimuli

Airway clearance, Ineffective related to coughing and mucous production.

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