Chronic bronchitits Flashcards
patient chief complaint
chronic productive cough
caused by inflammation bronchi
primary cause of chronic bronchitis
decline fev1
increased incidence of pulmonary infection
increase incidence of chronic bronchitis and emphysema
discuss the etiology of chronic bronchitis
cigarette smoker suffer more
non-smoker can cause chronic bronchitis and can be cause of repeated pulmonary infection
occupation al exposure to irritants and can cause air pollution
airway change in chronic bronchitis
increase mucous production
bronchial mucous glands enlarge
goblet cells increase in number
airway changes
loss of cilia in airway
increase mucous production and impaired ciliary activity lead to airway plugging
airway plugging can cause v/q mismatch and cause chronic hypoxemia
affect of airway resistance
increase airway resistance is dependent upon the severity of the disease
as mucous production increases the airway resistance increase
pulmonary vasoconstriction
cause by the chronic hypoxemia
academia can cause the pulmonary vessels to constrict further
increase in pulmonary vascular resistance increase the work load on the right heart
and may lead to right heart failure or for pulmonale
history of cough
determine if patient acknowledges the presence of a chronic bronchitis
some patient may not determine when the cough started
most patients present when there is an acute pulmonary infection on top of their chronic symptoms which can lead to more acute phase of dyspnea
history of mucous production
determine the color and amount of mucous
Stable bronchitis-has white or mucoid mucous
infection present - is hello/green and much thicker and more purulent
also allergic reaction may also change the color and consistency
what some other symptoms of bronchitis
hemoptysis
chronic infection and irritation and chronic cough
severe disease
fever (evaluate infection)
cyanosis can be present
pedal edema and liver enlargement which is further sign of cor pulmonale
ches evaluation would show
use of accessory muscle
crackles, rhonchi and wheezes
loud pulmonic valve closure
jungular venous distension( poor man’s CVP)
RBC are elevated indicating what ___________?
chronic hypoxemia (polycethemia)
What is elevated during infection and what for what?
elevation in WBC and what for left shift elevation in bands indication a major infectious process
blood gases in severe diseases
respiratory acidosis may be compensated
hypoxemia
