Bronchiectasis is a chronic lung condition characterized by abnormal dilation of the bronchi. It can be caused by airway obstruction, pulmonary infections, genetic disorders like cystic fibrosis, or idiopathic factors. Symptoms include persistent cough with large amounts of sputum, hemoptysis, and clubbing of the fingers. Diagnosis is made through chest imaging like HRCT. Treatment focuses on clearing secretions through postural drainage, chest physiotherapy, antibiotics, bronchodilators, and smoking cessation. Nursing management centers on helping patients perform breathing exercises and techniques to clear pulmonary secretions.

1. BRONCHIECTASIS

2. ANILKUMAR BR
LECTURER
Medical-surgical nursing

3. Definition
• 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

4. Bronchiectasis

5. Bronchiectasis

6. Etiopathophysilogy
• Bronchiectasis is characterized by permanent,
abnormal dilation of one or more large bronchi.
• The pathophysiogic change that results in dilation is
destruction of the elastic and muscular structures
supporting the bronchial wall.

7. • The disease process results in a reduced ability to
clear mucus from the lungs and decreased expiratory
air.

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• The variety of pathophysiogic process can result in
bronchiectasis.
• Primary disorders of structures in the bronchi ( cartilage
defects)
• Disease of mucus clearance (cystic fibrosis) infections
• Etiologies (severe child hood bronchial infections) and
inflammatory disease (ulcerative colitis)

9. Bronchiectasis may be caused by a variety of
conditions :
• Airway obstruction
• Diffuse airway injury
• Pulmonary infections (complications of long term Pulmonary
infection)
• Genetic disorder (cystic fibrosis)
• Abnormal host defense
• Idiopathic cause

10. Clinical manifestations
• The hall mark of bronchiectasis is persistent or
recurrent cough with production of large amounts
of purlent sputum that may exceed 500ml /day.
• Many patients with this disease have Hemoptysis
• Clubbing of the fingers also common because of
respiratory insufficiency.

11. Others manifestations including mainly
• Dyspnea
• Wheezing and pleurtic chest pain

12. Assessment and diagnostic findings
• History collection and Physical Examination
• Chest x-ray
• HR CT (High – resolution computed tomography)
is gold standard for diagnostic bronchiectasis , it
will show either the presence or absence of
bronchial dilation.

13. Medical management
• Treatment objectives are promote bronchial
drainage to clear excessive secretions from
affected portion of the lungs and prevent
control infections.

14. Medical management
• Postal drainage (PD) is the part of all treatment
plans.
• Some time mocopurelent sputum are removed by
bronchoscopy.
• Chest physiotherapy (CPT) , including PD,
percussion are important to management of
secretions.

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• Smoking cessation is major important because of
the smoking impairs bronchial drainage and
increasing bronchial secretions and causing
information of the mucous membrane.
• Antimicrobial therapy based on the sensitivity test
• Patient should be vaccinated against influenza and
pnemococcal pneumonia.

16. • Bronchodilator are the also treatment choice
• Encourage patients to perform effective coughing
and deep breathing exercises.
• Hydration of patient unless contraindicated, 3
liters /day it is help to the thicking of the
secretions.

17. Surgical management
• Surgical intervention although used infrequently. The
goals of surgical therapy to conserve normal
Pulmonary tissue and avoid the infectious and
complications.
• Surgical intervention depending the on the patient age
and cardio Pulmonary status and other conditions.

18. • Segmental resection (segment of a lobe)
• Lobectomy (removal the lung lobe)
• Pnemonectomy (removal of the entire lung)

19. Summary of medical management patients
with bronchiectasis
• Antibiotics and Antimicrobial therapy
• Postral drainage
• Chest physiotherapy
• Smoking cessation
• Bronchodilator
• Maintain hydration status
• Breathing exercises

20. Nursing management
• Nursing management of patients with bronchiectasis
focuses on alleviating and helping patients clear
Pulmonary secretions.
• Patients teaching targeted mainly smoking cessation and
breathing exercises
• Patients and family members should taught to perform
the PD and avoid expose to people with upper respiratory
tract infections.

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• The patient should taught early signs and
symptoms of respiratory infections and
progression of the disorder, so that
appropriate treatment can be implemented
promptly.

22. • The presence of large amount of mucus may
decrease the patients appetite and results in an
inadequate dietary intake, therefore the
patients nutritional status assessed and
strategies to important ensure to adequate
nutrition.

23. • Maintaining the patient hydration status is major
important encourage patient to take fluid at least 3
liters per day unless contraindicated.
• Assist in PD and CPT
• Encourage patient to perform deep breathing and
effective coughing techniques
• Provide adequate rest.