Chronic Bronchitis
Signs/Symptoms - General
cough is prominent
vigorous coughing produces sputum
typically overweight, with prominent peripheral edema and chronic jugular vein distention
chronically cyanotic complexion
minimal difficulty breathing + anxiety unless in respiratory failure
SpO2 reading <94% indicating chronic hypoxemia
scattered rales/crackles at bases of lungs
asterixis may be seen in respiratory failure
flapping of extended wrists
Treatment - Supportive
head-up position of comfort
O2 until SpO2 of at least 94%
watch for signs of decompensation during transport
decreased mental status
decreased respiratory rate w/ decreased SpO2
CPAP if pt doesn't improve w/ simple O2 administration
Pathophysiology
inflammation, swelling, + thickness of lining of bronchi+bronchioles + excessive mucus production
ability to oxygenate blood decreases as disease progresses
restrict flow to alveoli which cannot fully expand
causing respiratory distress + possible hypoxia
narrow airways
high resistance + chronic difficulty breathing
recurrent infections leave scar tissue - further narrowing
leads to hypercarbia + hypoxemia
pulmonary capillary bed + alveoli are undamaged
reduced ventilation in alveoli + increased blood flow through capillary
leads to hypoxemia + hypercapnia (CO2 retention in blood) + possible increased production of RBCs
causes heart to work much harder
heart failure may be seen when respiratory distress develops
Facts
disease process that primarily affects the bronchi + bronchioles
associated w smoking
characterized by a productive cough that persists for at least 3 consecutive months a year for at least 2 consecutive years
Signs/Symptoms - Exclusive
cyanotic complexion