week 9 bronchiectasis

Question 1

define bronchiectasis

Answer 1

-acquired disorder of the major bronchi and bronchioles that:
1. Chronic dilation and distortion of one or more bronchi
2. Usually because of extensive inflammation and destruction of the bronchial wall cartilage, blood vessels, elastic tissue, and smooth muscle components

Question 2

common causes of bronchiectasis.

Answer 2

1.Cystic fibrosis is the most common cause of bronchiectasis in children

2.Most all causes of bronchiectasis include some combination of bronchial obstruction and infection

Question 3

which part of the lungs are infected by bronchiectasis

Answer 3

-Commonly limited to a lobe or segment and is frequently found in the lower lobes

-Smaller bronchi with less support cartilage, are predominantly affected

Question 4

what are the pathological or structural changes

Answer 4

1.Chronic dilation and distortion of bronchial airways

2.Excessive production of often FOUL-smelling sputum

3.Bronchospasm

4.Hyperinflation of alveoli (air trapping)

5.Atelectasis

6.Consolidation and parenchymal fibrosis

7.Hemoptysis secondary to bronchial arterial erosion

Question 5

clinical manifestations of bronchiectasis

Answer 5

-Increased alveolar-capillary membrane thickness

-Excessive bronchial secretions

-Bronchospasm

-Atelectasis

Question 6

physical examination of pt with bronchiectasis

Answer 6

1. Vital signs
   -Tachypnea
   -Tachycardia
   -Hypertension

2.Use of accessory muscles inspiration/expiration

3.Purse lip breathing

4. Barrel chest

5.Cyanosis

6.Digital clubbing

7.Distending neck veins

8.Pitting edema

9.enlarge/tender liver

10.Cough & sputum
-Large quantities
-Foul smelling sputum (fetid)

Question 7

clinical data- lab test

Answer 7

-Hematology:
↑ Hct and Hb
↑ WBC

-Sputum culture:
Purulent
Fetid
Separates into 3 layers
-Foam layer
-Liquid layer
-Pus layer

Question 8

chest radiograph of bronchiectasis

Answer 8

-Depressed or flattened diaphragm
-Elongated heart
-Enlarged heart
-Areas of atelectasis and consolidation
-Tram-tracks

Question 9

what is the general management for treating bronchiectasis

Answer 9

*Treatment of the underlying disease may not be possible

-General treatment plan:
1. Controlling pulmonary infections

2.Preventing complications

3.Vaccinations (early childhood)

4.Lung resection

Question 10

what are the respiratory care treatment protocol

Answer 10

1. Oxygen therapy

2.Airway clearance therapy protocol
-CPT w/ PD, HFCWO,PEP

3.Lung expansion therapy
-Deep breathing
-Effective cough

4.Aerosolized medications
-Bronchodilators