broncho ectasis

7/31/2019 Broncho Ectasis

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The classic clinical manifestations ofbronchiectasis are cough and dailymucopurulent sputum production, oftenlasting months to years. Blood-streakedsputum or hemoptysis may result from airwaydamage associated with acute infection. Lessspecific symptoms include dyspnea, pleuriticchest pain, wheezing, fever, weakness, andweight loss.


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Weight changes(weight loss) Finger Clubbing( Cystic Bronchoectasis)

Nasal mucosa(rhinitis,pus =PCD)

Sputum(Hemoptysis) Spirometry

Ambulatory desaturation

Echocardiography(PHTN,right heart

Dysfunction)


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When listening to the chest with a stethoscope, the doctormay hear small clicking, bubbling, wheezing, rattling, orother sounds, usually in the lower lobes of the lungs.

Tests may include: Aspergillosis precipitin test (to check for signs of the

aspergillosis fungus) Alpha-1 antitrypsin blood test Chest x-ray Chest CT Sputum culture Complete blood count (CBC) Genetic testing, including sweat test for cystic fibrosis PPD skin test to check for a prior tuberculosis infection Serum immunoglobulin electrophoresis


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Drainage by gravity of secretions from various lungsegments

Forceful striking of the skin with cuff hands

Purpose: promote bronchial drainage to clear

excessive secretions from the affected portion ofthe lungs to prevent or control of infection


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SMOKING CESSATION:smoking impairs bronchial drainage byparalyzing ciliary action, increase bronchialsecretions and causing inflammation of themucous membrane, resulting in hyperplasiaof mucous glands


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ANTIMICROBIAL THERAPY: used to help fight respiratory infections

physicians prescribe antibiotics throughout

winter or when acute respiratory tract occurs


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Inhaled asaerosol sprays or taken orally, bronchodilatormedications may help to relieve symptoms ofbronchiectasis by relaxing and opening the

air passages in the lungs.


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Inhaled as an aerosol spray,steroids can help relieve symptoms ofbronchiectasis. Over time, however, inhaledsteroids can cause side effects, such as

weakened bones, high blood pressure,diabetes and cataracts. It is important todiscuss these side effects with your doctorbefore using steroids.


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Mucusthinners and expectorants help loosen andclear mucus from lungs.


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SEGMENTAL RESECTION: a.k.a. Segmentectomy

Removal of a segment of a lobe

LOBECTOMY

removal of lobe of a lung

PNEUMONECTOMY removal of the entire lung

Removal of the right is more dangerous thanthe left because right has a larger vascular bed

and its removal imposes a greater physiologicburden


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Is the same as for COPD

Provide supportive care and

help the patient adjust to thelifestyle changes thatirreversible lung damagenecessitates

Administer antibiotics, asordered, and record patientsresponse to this medication.

Give oxygen as needed.


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Management forBronchiectasis

Perform chest physiotherapy,including postural drainageand chest percussion forinvolved lobes, several timesper day, especially earlymorning and before bed time.

Provide warm, quiet,comfortable environment.Also help the patient toalternate rest and activityperiods.


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Give the patient wellbalanced, high caloric meals.

Offer small, frequent meals ornutritional supplements.

Make sure the patientreceives adequate hydration

to help thin secretions andpromote easier removal.


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Give frequent mouth care toremove foul-smelling

sputum. Provide the patient with

tissues and waxed bag inwhich to dispose

contaminated tissues.Monitor the patients

respiratory rate and patternregularly


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Asses gas exchange bymonitoring ABG values as

orered.Observe the patients breath

sounds and sputumproduction for changes that

might indicate a respiratoryinfection or worseningcondition.


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It may be treated by: Surgical Resection if the pathologic process is

well localized in one lobe or two adjacentlobes and when no contraindications to

surgery exists.

broncho ectasis

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