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Chronic Obstructive Pulmonary Chronic Bronchitis (Diagnostic findings…
Chronic Obstructive Pulmonary
Chronic Bronchitis
Causes
Smoking
Occupational exposure
Genetic abnormalities
Definition
Chronic bronchitis is a disease of the airways and is defined as the presence of cough and sputum for at least 3 months in each 2 consecutive years. Allergens irritate the airways and leads to the production of the sputum by goblet cells
Pathophysiology
Airway obstruction leads to hypoxia and pulmonary vasoconstriction , high resistance in pulmonary hypertension causes reduced circulating blood volume.
Clinical Manifestations
Chronic cough
Sputum production
Dyspnea on exertion
Dyspnea at rest. As COPD progress, dyspnea at rest may occur.
Weight loss
Barrel chest
Diagnostic findings
Health history
Spirometry
ABG
Chest x-ray
CT scan
Screening for alpha1-antitrypsin deficiency
Pulmonary function tests
Pharamacologic Therapy
Bronchodilators
Corticosteroids
Other pharmacologic treatments that may be used in COPD include augmentation therapy, antibiotic agents, mucolytic agents, antitussive agents,
Nursing Management
Optimization of bronchodilator medications
Oxygen therapy. Upon arrival of the patient in the emergency room, supplemental oxygen therapy is administered
Antibiotics
Hospitalization
Nursing Assessment
Health care worker should assess patient’s exposure to risk factors.
Assess the patient’s past and present medical history.
Assess the signs and symptoms of COPD and their severity.
Assess the patient’s knowledge of the disease.
Health care worker should assess the vital signs
Health care worker should assess breath sounds and pattern.
Nursing intervention
Diaphragmatic breathing helps in reducing respiratory rate
Controlled coughing the nurse should instruct the patient in direct coughing
inspiratory muscle training
The nurse should administer corticoteroids appropriately
Exercise training helps to strengthen muscles
The nurse should advise the patient to stay immunized against influenza