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