2. Bronchiectasis is defined as a permanent dilation of the
bronchi. It seems to be a consequence of previous lung diseases,
especially lung infections that were not treated sufficiently. Clinically,
the disease manifests as recurrent episodes of respiratory tract
infections together with an enduring cough and continuous production
of sputum. The treatment of bronchiectasis remains a challenge due to
the multiple causes and facts of the disease. pharmacological therapy
is aimed at the reduction of microbial invasion with antibiotics,
Effective prevention measures such as smoking cessation and
vaccines may prevent disease exacerbations.
introduction
4. 2) Bronchiectasis is a chronic, irreversible dilation of the bronchi
and bronchioles
OR
Bronchiectasis is characterized by permanent, abnormal dilation of
one or more large bronchi
3) Bronchiectasis is a condition anatomically defined by chronic,
irreversible dilation and distortion of the bronchi caused by
inflammatory destruction of the muscular and elastic
components the bronchial walls.
4) It connection with inflammation of the bronchi , particularly when
this leads to weakness of the walls with the accumulation of secretion.
SIR WILLIAM OSLER
CONT :
22. 1) ANTIBIOTICS-Initially during the acute phase amoxicillin,TMP or
Levofloxacin should be Started And later proper antibiotic should be chosen
accordingly to the sputum culture and Gram’s stain.
When pseudomonas is the organism oral Quinolone or parentral therapy
with aminoglycosides , carbapenam or third generation
cephalosporins should be given.
2) AEROSOLIZED ANTIBIOTICS-It is beneficial in treating Pseudomonas
infection, Currently the inhaled Tobramycin is most widely used.
Gentamycin and Colistin have also been used .
3) BROCHIAL HYGIENE-
1.postural drainage with percussion and vibration helps in effective clearance.
2.devices like flutter device,intrapulmonic percussive ventilation device and
incentive spirometry are available.
3.proper mechanical and devices with proper positioning of the patient can
help the patients with copious secretions
MEDICAL MANAGEMENT
23. 4)USE OF MUCOLYTICS can help thinning out the thick mucous
secretion.Use of recombinent DNAese which help in the destruction of
the DNA released by the neutrophiles has shown improvement in the
PF in case of CF.
5)BRONCHODILATORS help in the obstruction and clearance of the
bronchus.Use of nebulization concentrated with 7%NACL have shown
beneficial in CF-related bronchiectasis.
6)ANTI-INFLAMMATORY THERAPY- reduce the inflammation caused
by the organisms and subsequently reduce the tissue damage.
EX: inhaled corticosteroids,leucotriene inhibitors and NSAID
can be given.
CONT:
31. Nursing mangement depends upon the stages of bronchiectasis.The goal of
nursing management is to minimize the complication and preserve the health of
the child.
1)Assess the general condition ,vitals, respiratory status and ABG analysis.
2)Provide comfortable position ,warm and humid environment and propped
up position with extra pillows or by providing special bed
3)Administration of oxygen therapy to relieve dyspnea
4)Make airway clearance by suction or removal of secretions by steam
inhalation and physiotherapy
5)Provide extra fluid intake
6)Maintain calm,airy,warm and humid environment
7)Well balanced diet to provide extra calories.
8)Assist the chid in breathing exercise and postural drainage
9)Elevate anxiety by providing toys according to age
10)Educate parents regarding disease process,treatment and care
NURSING MANAGEMENT
32. NURSING DIAGNOSIS
1)Impaired gas exchange related to ventilation perfusion
inequality as evidenced by decreased level of spo2
GOAL-Improve in gas exchange.
NURSING INTERVENTION
1.Administer bronchodilators as prescribed.(inhalation is the
preferred route).
2.Instruct and encourage patient in diaphragmatic breathing and
effective coughing.
3.Administer antibiotics as prescribed.
4. Educate regarding types of indoor and outdoor air pollution.
33. 2)Ineffective airway clearance related to incresed mucus
production , ineffective cough , bronchopulmonary
infection, and other complications.
GOAL-Achievement of airway clearance.
NURSING INTERVENTION
1)Adequately hydrate the patient.
2)Use of diaphragmatic breathing and coughing techniques.
3)Assist in administering nebulizer.
4)Avoid bronchial irritants such as cigarette smoke, aerosal and
fumes.
5)Administer antibiotics as prescribed.
CONT:
34. COMPLICATIONOF BRONCHIECTASIS
1)Bronchopneumonia
2)Cerebral abscess due to septic purulent emboli may
travel from lungs into the arteries to the brain cause
cerebral abcess.
3)Pneumonia
4)Hemoptysis
5)Atelectasis
6)Pulmonary hypertension
7)Empyema
8)Septicemia
9)Recurrent pleurisy
10)Respiratory failure
