Introduction, meaning,definition,causes,pathophysiology, sign and symptoms,diagnostic evaluation, management

1. BRONCHIECTASIS
PRESENTED BY:
RADHIKA KULVI
M.Sc(N) 2ND YEAR

2. INTRODUCTION
Bronchiectasis is a condition where damage tubes causes
the lungs (airways) to widen or develop pouches. It makes
hard to clear mucus out of lungs and can cause frequent
infections. Coughing a lot with pus and mucus is the main
symptom of bronchiectasis. Bronchiectasis can’t be cured
but can be managed with treatment.

3. MEANING
Bronchiectasis is the abnormal, irreversible dilatation of
the bronchi.

4. DEFINITION
Bronchiectasis (Obstructive Lung disease) is an
irreversible widening (dilation) of portions of the
breathing tubes or airways (bronchi) resulting from
damage to the airway wall. The most common cause is
severe or repeated respiratory infections, often in
people who have an underlying problem with their
lungs or immune system.

5. TYPES OF BRONCHIECTASIS
CYLINDRICAL
BRONCHIECTASIS
VARICOSE
BRONCHIECTASIS
SACULAR
BRONCHIECTASIS
The most commonly
identified
morphologic type, is a
smooth uniform
enlargement of
bronchi without focal
out pouchings or
tortuosity.
It has irregular
contours with
alternating dilating
and contracting
lumen.
Also called Cystic
bronchiectasis is one
of the less common
morphological forms
. It may be present
on its own or may
occur in combination
with other forms of
bronchiectasis
.

7. CAUSES
• Airway obstruction
• Diffuse airway injury
• Pulmonary infections (complications of long
term Pulmonary infection)
• Genetic disorder (cystic fibrosis)
• Abnormal host defense
• Idiopathic cause

8. PATHOPHYSIOLOGY
Due to causative agents
Damages the bronchial wall, ( loss of its supporting
structure)
Resulting in thick sputum that ultimately obstructs the
bronchi.
The walls of bronchi become permanently distended
and distorted, impairing muco-ciliary clearance
The retention of secretions and obstruction ultimately
cause the alveoli distal
(ventilation– perfusion imbalance) and hypoxemia.
Bronchiectasis

9. CLINICAL MANIFESTATION
• Chronic cough
• Production of purulent sputum in copious
amounts
• Hemoptysis.
• Clubbing of the fingers
• Repeated episodes of pulmonary infection
• Weight loss
• Shortness of breath.
• Wheezing.

10. DIAGNOSTIC EVALUATION
• History collection
• Physical examination
• Chest x-ray
• Sputum studies.
• Pulmonary function test
• Arterial blood gas studies.
• Computed tomography.(CT scan)
• Bronchoscopy, Bronchogram

11. IMMEDIATE MANAGEMENT
• Oxygen Therapy
• Postural drainage : To promote bronchial
drainage & clear excessive secretions
• Bronchoscopy: To remove mucopurulent sputum.
• Chest physiotherapy, including percussion
• Antimicrobial therapy Based on type of infection.
• Influenza and pneumococcal vaccines .
• Bronchodilators: Theophylline
• Nebulizers. & Steam inhalation.

12. MEDICAL MANAGEMENT
• Antibiotics:Amoxicillin, Levofloxacin
• Bronchodialators:Albuterol, Salmeterol
• Antihistamines:Citrizine, Loratadine
• Corticosteroids:Fluticosone,Budesonide

13. SURGICAL MANAGEMENT
• Segmental resection to remove a segment of a lobe.
• Lobectomy : Removal of disesased part of a lobe
• Pneumonectomy: Removal of an entire lung

14. NURSING MANAGEMENT
• Assess the general condition .
• Collect complete history.
• Perform physical examination
• Provide comfortable bed & position.
• Provide nutritious diet
• Provide Oxygen According To Physician Order.
• Provide Psychological Support To Patient.
• Provide Knowledge About Bronchiectasis.
• Provide Suctioning and Maintain Hygiene of Patient
• Careful monitoring of the post-operative cases
• Provide Breathing & coughing exercises.
• Nebulization & steam inhalation

15. NURSING DIAGNOSIS
• Impaired gas exchange related to ventilation-
perfusion imbalance.
• Ineffective airway clearance related to increased
mucus production.
• Ineffective breathing pattern related to mucus and
airway irritants.
• Activity intolerance related to hypoxemia and
ineffective breathing patterns.

16. HEALTH EDUCATION
• Smoking cessation
• Lifestyle modification
• Nutritional balanced diet
• Appropriate treatment of respiratory
infection.
• Personal hygiene.