Bronchiectasis

Question 1

What is the definition of bronchiectasis?

Answer 1

a dilation of the bronchi and bronchioles, which is chronic in nature and results in inflammation and damage to the walls of these airways

Question 2

What are the causes of bronchiectasis?

Answer 2

chronic respiratory infections, tuberculosis lesions, secondary to patients with cystic fibrosis, bronchial obstruction

Question 3

What is the pathophysiology of bronchiectasis?

Answer 3

• chronic dilation resulting from destructive changes caused by inflammation infection and in some cases, congenital defects
• damage to the cilia along with dilation of the airway hinders mucociliary transport causing secretions to pool

Question 4

What are the clinical signs and symptoms associated with bronchiectasis?

Answer 4

• productive cough with large amounts of thick, purulent secretions, which may be foul smelling
• hemoptysis
• vital sign changes, typically what to expect from infection and hypoxemia
• blood gas changes
• other manifestations resulting from chronic hypoxemia

Question 5

How do blood gases change with bronchiectasis?

Answer 5

• respiratory alkalosis with hypoxemia (acute alveolar hyperventilation caused by hypoxemia)
• in severe cases: respiratory acidosis with hypoxemia (chronic alveolar hyperventilation caused by hypoxemia)

Question 6

What other bronchiectasis manifestations result from chronic hypoxemia?

Answer 6

• pulmonary hypertension causing cor pulmonale
• digital clubbing
• cyanosis

Question 7

What characteristics of bronchiectasis show up on a chest xray or CAT scan?

Answer 7

• chest xray may show cystic spaces resulting from the cystic form of bronchiectasis
• high resolution CT scanning
• characteristics of pulmonary function studies

Question 8

What are the characteristics of pulmonary function studies that show up on a chest xray?

Answer 8

decrease airflows and decrease in vital capacity

Question 9

What is the treatment for bronchiectasis?

Answer 9

• pulmonary hygiene
• aerosol therapy
• bronchodilator therapy
• mucolytics
• antibiotics
• oxygen therapy
• routine vaccinations
• pulmonary rehab, home care

Question 10

What are the different types of pulmonary hygiene?

Answer 10

• chest physical therapy
• ABI vest
• pep therapy
• flutter valve