The document provides a comprehensive overview of bronchitis, including its definition, types (acute and chronic), and management strategies. It describes the causes, pathophysiology, symptoms, diagnosis, treatment, and potential complications associated with bronchitis. Additionally, it outlines nursing care, preventive measures, and educational guidance for patients suffering from this respiratory condition.

1. PRESENTED BY MRS THRESAH K MWIINDE

2. GENERAL OBJECTIVES
At the end of the lecture
Student nurses should
understand Bronchitis
and its management.

3. SPECIFIC OBJECTIVES
 Define Bronchitis
 Mention the two types of Bronchitis
 List the predisposition factors of Bronchitis
 Describe the pathophysiology of Acute
and Chronic Bronchitis
 State the signs and symptom of Bronchitis
 Describe the management of Bronchitis
 State the complications of Bronchitis

4. DEFINITION OF ACUTE
BRONCHITIS
 Acute Bronchitis is an inflammation of
the lower respiratory tract
accompanied by coughing and
coughing up of phlegm. It can be
caused by exposure to a cold or the
flu, infection, or irritants. It takes less
than two weeks

5. DEFINITION
 Bronchitis is an inflammation
of the bronchi in the lower
respiratory tract usually due
to infection, characterized by
cough, wheezing and Dyspnea.

6. TYPES OF BRONCHITIS
There are 2 types of bronchitis:
• Acute bronchitis
• Chronic bronchitis

7. ACUTE BRONCHITIS
 Acute bronchitis is usually a self
limiting and treatment is supportive.
 Upto 90% of acute bronchial
infections are viral by origin
 Cough which is the most common
sign lasts for upto 3 weeks

8. ACUTE BRONCHITIS
When bronchitis is mild and
brief in duration, it is called
acute. It usually takes less
than 2 weeks

9. Acute Bronchitis
 This is the inflammation of the bronchial tree with minimal changes
in the parts affected.
 Acute bronchitis is characterised by the development of a cough or
small sensation in the back of the throat, with or without the production
of sputum.
 Acute bronchitis is most often caused by viruses that infect the
epithelium of the bronchi, resulting in inflammation and increased
mucus secretion.

10. Predisposing factors:
• Exposure to cold
• Irritants like cigarettes
smoke
• Very young and very old
• Dust
• Toxic gases
10

11. Causes of Bronchitis
• Microorganisms: viruses and bacteria
• Extension of infection from the
trachea
• Traumatic injuries
• Over exposure to industrial fumes.

12. Causes of Acute Bronchitis
 It is caused by both viruses and bacteria.
The main viruses are:
 Rhinoviruses
 Coronaviruses
 Adenoviruses

13. Causes of Acute Bronchitis
 Metapneumovirus
 Parainfluenza virus
 Respiratory syncytial virus
 Influenza.

14. Causes of Acute Bronchitis
 The main bacteria is:
 Mycoplasma pneumoniae,
 Chlamydophila pneumoniae,
 Bordetella pertussis,
 Streptococcus pneumoniae,

15. 15

21. PATHOPHYSIOLOGY
-The presence of an irritant like smoke or
infection will lead to inflammation which narrows
the air way.
-There will also be increased production of
secretions which will further impair air passage.
-Irritation of the respiratory tract will lead to
cough in an attempt to clear the air way.
-There may also be pain behind the sternum due
to the inflammation of the airways.

22. INCIDENCE
 Anyone can get acute bronchitis, but
infants, young children, and the elderly
are more likely to come down with the
disease. Smokers and people with heart or
lung diseases are at a higher risk of
developing acute bronchitis. Individuals
exposed to chemical fumes or high levels
of air pollution also have a greater chance
of developing acute bronchitis.

23. Signs and symptoms
 Cough due to irritation in the air way.
 Dyspnoea ( shortness of breath) due
to inflammation of the bronchial
airways.
 Soreness behind the sternum due to
the inflammatory processes.

24. Signs and symptoms
 Wheezing as air passes through the
fluid filled air way.
 Fever due to infection.
 In the initial stage sign of flu eg
running nose, sore throat, nasal
congestion, etc

25. Diagnosis
 History may reveal a predisposing factor
like Flu
 On Auscultation there will sign of
crepitations.
 Sputum for culture and sensitivity will
show the causative agent
 Bronchoscopy will show inflamed mucosal
membranes

26. Treatment
 If there is no bacterial infection treat
like flu
 If bacterial infection is present give
antibiotics like Amoxyl 500mg tds for
5/7
 Analgesic and antipyretics for pain
e.g. Panadol 1g tds 3/7

27. Treatment
 If dyspnea is present oxygen therapy may
be given
 Rest should be ensured
 Copious fluids to prevent dehydration
 Cough expectorants may be given.
 Broncho dilators may be given eg ventolin
4mg tid 3/7

28. Complications of acute
Bronchitis
 Chronic bronchitis
 Pneumonia
 Bronchiectasis; This is chronic
irreversible dilation of the bronchi and
bronchioles that results from the
destruction of the muscles and elastic
connective tissue

29. Complications of acute
Bronchitis
 Atelectasis:This is partial collapse or
incomplete inflation of the lungs
 Pnuemothorax;This is the
accumulation of air in the pleural
space through breach of either
Parietal or Visceral pleura

30. Complications of acute
Bronchitis
 Emphysema; Is a pathological term that
describes an abnormal distention of the air
spaces beyond the terminal bronchioles
and destruction of the walls of the alveoli
 Empyema;An accumulation of thick,
purulent fluid within the pleural space
often with fibrin development and loculated (
walled - off) area where infection is located.

32. INTRODUCTION
 Chronic bronchitis is caused by
inhaling respiratory tract irritants; it
may also be due to recurrent bouts of
acute bronchitis. The most common
cause, however, is the irritation of
cigarette smoke.

33. Chronic Bronchitis
 Chronic bronchitis is the
chronic inflammation of the
bronchi and fall under a group
of diseases that are collectively
known as chronic obstructive
pulmonary disease (COPD).

34. Chronic Bronchitis
Chronic Bronchitis is the
presence of cough and
sputum production for
atleast 3 months.

35. Chronic bronchitis is
recurrent, has a
prolonged course, and is
often a sign of a serious
underlying disease

36. Chronic Bronchitis
 Chronic bronchitis usually develops due to
recurrent injury to the airways caused by
inhaled irritants. Cigarette smoking is the
most common cause, followed by
exposure to air pollutants such as sulphur
dioxide or nitrogen dioxide, and
occupational exposure to respiratory
irritants.

37. Chronic Bronchitis
 Individuals exposed to
cigarette smoke, chemical lung
irritants, or who are
immunocompromised have an
increased risk of developing
bronchitis

40. Incidence continues
 Because this disease progresses slowly,
middle-aged and older people are more
likely to be diagnosed with chronic
bronchitis
 Chronic bronchitis shows symptoms similar
to acute bronchitis, but it recurs and is
present for at least three months a year

41. Causes of Chronic Bronchitis
Most cases of chronic bronchitis are caused
by:
 Smoking cigarettes or other forms of
tobacco.
 Chronic inhalation of air pollutants,
irritating fumes or dust from hazardous
exposures in occupations such as coal
mining.

42. Causes of Chronic Bronchitis
• Grain handling.
• Textile manufacturing.
• Livestock farming.
• Metal moulding may also be a risk factor
for the development of chronic bronchitis.

43. Pathophysiology
 In many cases smoke or other
environmental pullutants irritate the
airways resulting in inflammation.
 Smoking will cause the destruction of
the cillia by shortening and making
them to be less motile

44. Pathophysiology
 Constant irritatation will stimulate the
mucus glands to hypersecrete the mucus
to coat the area
 Persistent irritation causes hypertrophy
and hyperplasia of the mucus secreting
glands and the goblet cells.
 Increase in number leading to increased
mucus production

45. Pathophysiology
 Mucus plugging of the airway reduces
cilliary function, air is trapped leading
to hypoxia and hypercapnia
(hypercarbia)
 Bronchial walls also become
thickened further narrowing the
bronchial lumen.

46. Pathophysiology
 Alveoli adjacent to the bronchioles
may become damaged ,fibrosed and
develop scars resulting in altered
function of the alveolar macrophages
making the patient susceptible to
other infections

47. 47

48. Signs and Symptoms of
Chronic Bronchitis
 The main signs and symptoms
are:
 Chronic cough due to repeated
irritation.

49. Signs and Symptoms of
Chronic Bronchitis
 Copious sputum that is thick and
brown in colour resulting from
increased production of mucus from
the goblet cells.
 Haemoptysis due to bleeding in some
parts of the bronchi.

50. Signs and Symptoms of
Chronic Bronchitis
 Dyspnoea due to constriction of the
bronchiole tree resulting from inflammation
and presence of mucus.
 Chest pains due to reduced air spaces.
 Cyanosis due to hypoxia
 Fever due to fever.
 Wheezing due to accumulation of mucus
in the airway

51. Treatment
 Antibiotics if the cause is bacterial, e.g.,
Ampicillin.
 Anti-inflammatory drugs such a
prednisolone.
 Cough expectorants, e.g., Ammonium
chloride.

52. Treatment
 Steam inhalations to liquefy
secretions.
 A warm, well ventilated room.
 Light diet with plenty of fluids.

53. Prevention
 Stopping smoking
 Prompt treatment of respiratory tract
infections
 Avoiding respiratory irritants

54. NURSING CARE
 Aims;
 To relieve Dyspnea
 To promote quick recovery
 To educate the patient on the need to
stop smocking
 To prevent complications
 To maintain a good nutritional status

55. Environment
 Patient will be nursed in a well ventilated
room to prevent other respiratory tract
infection
 Patient will be nursed in a well lit room
for easy observation and for orientation to
time and place
 Patient will be nursed in a general ward
but reverse barrier nursing will be used to
prevent acquisition of nosocomial
infections

56. Environment
 Will include the oxygen giving
apparatus for use because patient is
dyspneic
 will include the drip stand in the room
for IVI when need arises

57. Position
 Patient will be nursed in fowlers position
to promote lung expansion and relieve
dyspnea
 I will change the patient’s position two
hourly to prevent development of pressure
sores
 As the condition improves I will let the
patient adopt any position of comfort to
promote rest

58. Rest
 I will nurse the patient in a quiet room to
promote rest
 I will play the radio at low volume to
promote rest
 I will answer all phone calls promptly to
prevent disturbing the patient there by
promote rest

59. Rest
 I will do related procedures in blocks to
promote rest
 I will administer prescribed analgesics in
order to promote rest
 I will ensure that squeaking trolleys a
oiled to prevent noise and there by
promote rest

60. observations
 I will do vital sign and BP to act as the
base line data in order to know if the
condition is improving or deteriorating
 I will observe for cyanosis if improving or
getting worse and give oxygen therapy
when necessary
 I will observe Dyspnea if present will prop
up the patient to promote lung expansion
and there by relieve dyspnea

61. observations
 I will observe the pressure area to
detect on set of pressure sore
development
 I will observe the sputum for colour
amount and consistency to detect
haemoptysis and report the physician

62. observations
 I will observe the patient’s facial
expressions to detect pain and administer
prescribed analgesics like panadol
 I will observe the feeding pattern of my
patient and take measures like giving
small frequent meals to promote appetite
 I will observe the respirations to detect
tachycardia and report accordingly

63. Psychological care
 I will explain the disease process in order
to raise the knowledge levels and thereby
alley anxiety
 I will encourage the patient to ask
question and I will answer accordingly
those I cant answer I will refer to the
physician
 I will explain all procedures to my patient
in order to allay anxiety

64. Psychological care
 I will involve a successfully managed case
to come and talk to my patient in order to
allow the patient ask pressing question
and get answer this will improve the
patients out look on his condition
 I will involve the loved ones in his care in
order for him not to feel neglected.
 I will provide diversional therapy in order
to shift the patient’s mind from the
hospital routine and his condition

65. Psychological care
 I will involve him in planning his own care
in order for him not to feel left out
 I will explain to him that as the health
care team we are doing everything
possible to ensure that he get better in
order to promote co-operation.

66. Hygiene
 I will encourage the patient to take plunge baths
in order to remove dead epithelium and promote
comfort
 I will do hair care to promote self esteem and
also prevent pediculosis
 I will do nail care to prevent auto infection
 I will do mouth care to prevent halitosis
 Any soiled linen and clothes will be changed to
promote comfort

67. Elimination
 I will provide copious fluids in order to
promote renal wash out and there by
prevent renal problems
 If my patient is confined to bed I will give
a bed pan to promote bowel movement
 I will provide a lot of fluids and roughage
to prevent constipation

68. Nutrition
 I will provide energy giving foods like
inshima to provide the energy needed for
the metabolic processes
 I will provide protein foods like fish and
beans to promote replacement of worn
out tissues
 Vegetables and fruits will be provided to
raise the immunity and promote skin and
mucous membrane integrity

69. Nutrition
 I will provide a lot of oral fluids to prevent
dehydration due to fever and vomiting
 I will serve small frequent meals to
promote appetite
 I will allow visitors to bring food preferred
by the patient in order to promote
appetite
 I will do regular mouth washes in order to
promote appetite

70. Exercises
 I will encourage the patient to do deep
breathing exercises in order to promote lung
expansion
 I will encourage early ambulation as soon as the
condition permits in order to prevent deep vein
thrombosis and other complications of
immobility
 If my patient is confined to bed i will do passive
exercises like limb movement and massage in
order to prevent muscle atrophy and promote
blood circulation

71. medication
 I will administer prescribed analgesic like
panadol at the right time to promote rest
 I will give prescribed antibiotics like amoxil
to promote quick recovery
 I will ensure that the drugs are swallowed
in my presence to promote recovery.

72. Information, Education and Communication
 Advise the patient to avoid crowds
and people with known infections,
and to obtain influenza and
pneumococcus immunizations.
 .

73. Information, Education and Communication
 Teach the patient and family how to
perform postural drainage and chest
percussion. Instruct the patient to maintain
each position for 10 minutes before a
caregiver performs percussion and the
patient coughs. Also teach the patient
coughing and deep-breathing techniques
to promote good ventilation and to remove
secretions

74. Information, Education and Communication
 Review all medications, including dosage,
adverse effects, and purposes for the
prescriptions. Advise them to report any
adverse reactions to the doctor
immediately.

75. Information, Education and Communication
 Encourage the patient to eat high-calorie,
protein-rich meals and to drink plenty of
fluids to prevent dehydration and help
loosen secretions
 If the patient smokes, advise them to stop.
Provide them with lessons on how to stop
smoking and counselling if necessary.

76. Information, Education and Communication
 Urge the patient to avoid irritants such as
automobile exhausts fumes, aerosol sprays, and
industrial pollutants.
 Warn the patient that exposure to blasts of cold
air may precipitate bronchospasms. Suggest
that they avoid cold, windy weather by covering
their mouth and nose with a scarf or mask if they
must go outdoors.

77. Information, Education and Communication
 If the patient takes theophylline
(bronchodilator), warn them that smoking
cigarettes or marijuana significantly
increases plasma clearance of
theophylline. Also, patients who quit
smoking should notify the doctor because
they may experience the onset of the
adverse effects of higher blood levels of
theophylline

78. Information education and
communication
 I will talk to the patient about the
need to take a balanced diet
using locally available foods in
order to boost the immunity
 I will educate the patient about
the need keep the review dates
so that his progress is monitored
to ensure full recovery

79. Complications
 Acute respiratory failure.
 Pneumonia due to spread of infection.
 Right side heart failure due to
increased pressure on the right side
of the heart in order to push blood
into the lungs.

80. Complications
 Bronchopneumonia with repeated
infections of the lower respiratory tract.
 Cor –pulmonale (pulmonary heart disease)
comes as a result of obstruction in the
lungs.

81. Complications
• Atelectasis, This is the
complete collapse of a lung.
• Bronchiectasis due to chronic
dilatation of the bronchi and
destruction of the bronchial
walls