Disorders of Respiratory system and Nursing Care

1. ACUTE BRONCHITIS
Mr.Veerabhadra.B.Badiger
Asst Professor
Dept of Medical Surgical Nsg

2. ACUTE BRONCHITIS.
 Acute bronchitis is an inflammation of the bronchi in the
lower respiratory tract. The inflammation also involves the
mucous membrane of the trachea.
 Acute bronchitis typically lasts less than 10 days, but the
coughing can continue for several weeks.

3. CAUSES OF ACUTE BRONCHITIS:
 Viral infection (85 to 95 percent)
 Bactertial infection (Mycoplasma pneumoniae
, Chlamydia pneumoniae, and Bordetella pertussis ).
 Smoking
 Elderly people being very susceptible;
 Malnutrition
 Air pollutions
 Poor ventilation
 Overcrowding
 Occupations exposures whereby irritant particles are
inhaled,

4. RISK FACTORS
Factors that increase your risk of acute bronchitis
include:
 Cigarette smoke , including secondhand smoke
 Weakened immune system
 Gastric reflux
 Frequent exposure to irritants, including dust or
chemical fumes
 Lack of vaccinations for the flu, pneumonia, and
whooping cough
 Age older than 50 year

5. PATHOPHYSIOLOGY
Due to etiology
Inflammation of mucous membrane of the trachea
and bronchi , later it become congested and
swollen
But soon becomes opaque, and finally muco-
purulent.
swelling of the mucous glands & smaller bronchial
tubes are dilated.
Mucosa becomes infiltrated with leukocytes causes
narrowing of bronchi.

6. CLINICAL MANISFESATION
 Common cold
 Throat is dry and rough , sore throat
 Voice is hoarse.
 Fever (100°F to 100.4°F (37.7°C to 38°C)
 Cough with expectoration
 Dull pain in the chest.
 Wheezing
 Malaise
 Generalised weakness.
 Coated tongue
 Headache.

7. DIAGNOSTIC STUDIES
 History collection
 Physical examination : Chest auscultation
( Rhonchi sounds).
 Chest x-ray
 Sputum analysis.
 Arterial blood gas studies..
 Spirometry
 Pulmonary function test
 CT / MRI Chest

8. Spirometry
Pulmonary function test

9. MANAGEMENT
Symptomatic Management
 NSAID’s (Analgesics) & Anti-inflammatory
:Ibuprofen and Naproxen
To relieve pain , reduce fever& inflammation. Cough
suppressants.
 Corticosteroids: prednisolone. To control inflmmation.
 Antibiotics: Based on causative agent.(Amoxicillin,
Oxytetracycline or Doxycycline.)
 Bronchodilators. Ipratropium , Theophylline

10.  Oxygen Therapy
 Nebulization. (Albuterol)
 Steam inhalation.
 Nutritional diet.
Surgery: Lung transplant is optional in case lung
is severe damaged

11. NURSING DIAGNOSIS
Impaired gas exchange related to
obstructed airways.
Ineffective breathing pattern related to
excess mucus production.
Activity intolerance related to
breathlessness.

12. NURSING CARE.
 Check Respiratory status of the patient.
 Provide comfortable bed & position.
 Monitor vital signs & spo2
 Encourage ambulation, coughing, and deep
breathing.
 adequate fluid intake to liquefy secretions.
 Encourage rest, avoidance of bronchial irritant.
 Administer oxygen & medications as ordered.

13. CHRONIC BRONCHITIS
.

14. CHRONIC BRONCHITIS
A repeated inflammation of the mucous membrane
of the trachea and bronchi, that causes continuous
irritation & swelling of airways.
Causes
 Pneumonia
 Organic heart disease
 Rheumatism
 Syphilis
 Tuberculosis
 Chronic alcoholism
 Chemical irritants.

15. CLINICAL MANIFESTATION
Cough, the expectoration
Difficulty in breathing, causing
exhaustion
Fever with chills
Tachypnoea
Tachycardia
Tight chest

16. DIAGNOSTIC STUDIES
 History collection
 Physical examination.
 Pulmonary function test
 Chest x-ray
 Computed tomography of chest
 Arterial blood gas studies.
 Sputum studies
 Complete blood count: WBC count
 Blood culture.

17. MANAGEMENT
 Same as acute bronchitis…… Additionally
 Oxygen therapy
 Anti-inflammatory agents: Steroids.
 Antibiotics: Based on agents
 Antipyretics.
 Branchodilator.
 Nebulization
 Steam inhalation.

18. NURSING MANAGEMENT
 Provide comfortable bed & position
 Assess vital signs ( Spo2, Pao2, Paco2)
 Administer oxygen if required.
 Provide well balanced diet
 Health education on personal hygiene , medication
,Follow-up care.
 Deep breathing & coughing exercises.
 Steam inhalation