Broncho Ectasis
Transcript of Broncho Ectasis
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The classic clinical manifestations ofbronchiectasis are cough and dailymucopurulent sputum production, oftenlasting months to years. Blood-streakedsputum or hemoptysis may result from airwaydamage associated with acute infection. Lessspecific symptoms include dyspnea, pleuriticchest pain, wheezing, fever, weakness, andweight loss.
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Weight changes(weight loss) Finger Clubbing( Cystic Bronchoectasis)
Nasal mucosa(rhinitis,pus =PCD)
Sputum(Hemoptysis) Spirometry
Ambulatory desaturation
Echocardiography(PHTN,right heart
Dysfunction)
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When listening to the chest with a stethoscope, the doctormay hear small clicking, bubbling, wheezing, rattling, orother sounds, usually in the lower lobes of the lungs.
Tests may include: Aspergillosis precipitin test (to check for signs of the
aspergillosis fungus) Alpha-1 antitrypsin blood test Chest x-ray Chest CT Sputum culture Complete blood count (CBC) Genetic testing, including sweat test for cystic fibrosis PPD skin test to check for a prior tuberculosis infection Serum immunoglobulin electrophoresis
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Drainage by gravity of secretions from various lungsegments
Forceful striking of the skin with cuff hands
Purpose: promote bronchial drainage to clear
excessive secretions from the affected portion ofthe lungs to prevent or control of infection
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SMOKING CESSATION:smoking impairs bronchial drainage byparalyzing ciliary action, increase bronchialsecretions and causing inflammation of themucous membrane, resulting in hyperplasiaof mucous glands
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ANTIMICROBIAL THERAPY: used to help fight respiratory infections
physicians prescribe antibiotics throughout
winter or when acute respiratory tract occurs
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Inhaled asaerosol sprays or taken orally, bronchodilatormedications may help to relieve symptoms ofbronchiectasis by relaxing and opening the
air passages in the lungs.
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Inhaled as an aerosol spray,steroids can help relieve symptoms ofbronchiectasis. Over time, however, inhaledsteroids can cause side effects, such as
weakened bones, high blood pressure,diabetes and cataracts. It is important todiscuss these side effects with your doctorbefore using steroids.
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Mucusthinners and expectorants help loosen andclear mucus from lungs.
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SEGMENTAL RESECTION: a.k.a. Segmentectomy
Removal of a segment of a lobe
LOBECTOMY
removal of lobe of a lung
PNEUMONECTOMY removal of the entire lung
Removal of the right is more dangerous thanthe left because right has a larger vascular bed
and its removal imposes a greater physiologicburden
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Is the same as for COPD
Provide supportive care and
help the patient adjust to thelifestyle changes thatirreversible lung damagenecessitates
Administer antibiotics, asordered, and record patientsresponse to this medication.
Give oxygen as needed.
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Management forBronchiectasis
Perform chest physiotherapy,including postural drainageand chest percussion forinvolved lobes, several timesper day, especially earlymorning and before bed time.
Provide warm, quiet,comfortable environment.Also help the patient toalternate rest and activityperiods.
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Give the patient wellbalanced, high caloric meals.
Offer small, frequent meals ornutritional supplements.
Make sure the patientreceives adequate hydration
to help thin secretions andpromote easier removal.
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Give frequent mouth care toremove foul-smelling
sputum. Provide the patient with
tissues and waxed bag inwhich to dispose
contaminated tissues.Monitor the patients
respiratory rate and patternregularly
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Asses gas exchange bymonitoring ABG values as
orered.Observe the patients breath
sounds and sputumproduction for changes that
might indicate a respiratoryinfection or worseningcondition.
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It may be treated by: Surgical Resection if the pathologic process is
well localized in one lobe or two adjacentlobes and when no contraindications to
surgery exists.