BRONCHIECTASIS

WHAT IS BRONCHIECTASIS?
 Bronchiectasis (brong-kee-EK-tuh-sis) is an
irreversible, chronic condition where
airways in the lungs (bronchi) become
damaged and abnormally widened, which
is caused by recurring inflammation and/or
infection, preventing the lungs from
properly functioning.
 HOW BRONCHIECTASIS IS
DAMEGE
 When air is inhale, it enters and leaves the lungs through
a series of branching airways called bronchial tubes.
Normally, these tubes narrow smoothly towards the
edges of each lung.
 The damage caused in bronchiectasis means that they
widen instead of narrowing.
 Cilia and mucus cover the linings of the bronchial tubes.
Mucus protects against unwanted particles that enter
the lungs. Cilia are like tiny hairs that sweep the
particles and excess mucus upwards, out of the lung.
 This is an ongoing process, although most people do not
notice the mucus coming out, except, for example,
during a seasonal cold.
 In bronchiectasis, damage to the cilia in the bronchial
tubes means they cannot sweep the particles and mucus
upward. Instead, particles and mucus accumulate. The
sputum becomes sticky and difficult to move, even with
coughing.
 As the sputum collects, bacteria also gather and start to
multiply, leading to Infections, further damage, and more
sputum.
The diagram showing normal
airway and Bronchiectasis
 CLINICAL MANIFESTATIONS:

The most common symptoms include:

a persistent, daily cough
 Cyanosis
 production of sputum
 chest pain or discomfort
 wheezing and shortness of breath
 Clubbing of fingers
 tiredness and fatigue
 Cont…
Later signs and symptoms may include:

 breathlessness
 difficultywalking more than 100 meters
without stopping
 frequent or severe chest infections
 weight loss
 slow growth in children
 fatigue
 blood in the mucus
 Hymoptysis (coughing up blood)
 Halitosis (Foul smelling breath)
 RISK FACTORS:
1. Infections
Infections that increase the risk include:
 tuberculosis (TB)
 pneumonia
 a fungal infection
 whooping cough early in life
 measles
2. Cystic Fibrosis
3. Allergic bronchopulmonary aspergillosis
(ABPA
4. Young’s Syndrome
5. Inhaling Toxic gases like amonia
 Cont…
 Inflammatory Bowel Disease(Crohn’s
Disease)
 Immunodeficiency disorders
 Chronic pulmonary aspiration
 Primary ciliary dyskinesia (PCD), or
Kartagener Syndrome (KS)
 Antitrypsin (A1AT) deficiency
POTENTIAL COMPLICATIONS:
 Atelectasis (collapsed lungs)
 Repeated infection
 Heart failure due to low oxygen
levels
 Respiratory failure, leading to low
oxygen levels
 Bleeding in the lung
PATHOPHYSIOLOGY
 DIAGNOSIS:
 Bronchoscopy – direct visualization of
bronchi lining using a fiberscope
 Chest X-ray may reveal areas of
atelectasis with widespread dilatation of
bronchi.
 Sputum examination- may detect offending
pathogens.
 High-resolution CT scan is useful in
diagnosis of bronchiectasis.
 Spirometry - use to measure lung function
 NURSING MANAGEMENT
 Encourage use of chest physical therapy techniques to empty
the bronchi of accumulated secretions

 Assist with postural drainage positioning for involved lung

segments to drain the bronchiectatic areas by gravity, thus
reducing degree of infection and symptoms.
 Use percussion and vibration to assist in mobilizing secretions.
 Encourage productive coughing to help clear secretions.

 Consider vaporizer to provide humidification and keep

secretions thin.
 Enforce Complete bed rest
 Low inflow O2 admin; (high inflow will cause respiratory arrest)
 CONT…
 Administer medications as ordered:

 Bronchodilators
 Antimicrobials
 Corticosteroids (5-10 minutes after bronchodilators)

 Mucolytics/expectorants
 Encourage increased intake of fluids to reduce
viscosity of sputum and make expectoration easier.
 Nebulize and suction client as needed
 Provide comfortable and humid environment
HEALTH TEACHINGS:
Avoidance of smoking.
Postural drainage.
Exposure to infections.
Importance of follow up care.