Ebook Respiratory nursing at a glance: Part 2
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Ebook Respiratory nursing at a glance: Part 2
BronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. Reproduce Ebook Respiratory nursing at a glance: Part 2ed wen permssicn ot L Ker erFigure 31.2 I he cycle of infection and inflammationSource: OzeroMtcn L. Wilson 11, nospsncfcnt Murse 2011: Aug 22:16-20.1 ỉeproaiBêđ with permssicn 01 MA I lealthcare Ltd.Figure 31.1 Dialed bronchi and mucus poolingSource; Boyton RJ. (2008). Bronctiiecta&s. AftxAcira.1. Ebook Respiratory nursing at a glance: Part 236; 31S-320.I.23C6.I. Reproduction with permsstcn ot Royal brcmpton Ạ Harefietd KUS Trust.Microbial infection(e.g. I isemopnuus Annvenzae)InflammationEbook Respiratory nursing at a glance: Part 2
hktulrophfic inflantm.trinn C.-ỊUTXSỈ dsmags to the tissue through proteolyticimpaired lung defencesTissue damage to epithelial eels and the structurBronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. Reproduce Ebook Respiratory nursing at a glance: Part 2017 by .otn Wiley A Sons. LtdPatients with bronchiectasis experience chronic productive cough, recurrent respiratory infections and an impaired quality of lite. Early diagnosis of bronchiectasis IS important so that specifc medical management can be instigated in order to establish control of sympto Ebook Respiratory nursing at a glance: Part 2ms, signifcantly improve health status and prevent progression.What is bronchiectasis?Bronchiectasis is defned as abnormal chronic dilatation of one oEbook Respiratory nursing at a glance: Part 2
r more bronchi (Bdton. 2003). T c dilated bronchi are caused by weakness and destruction of structural components of the bronchial wall and this togetBronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. Reproduce Ebook Respiratory nursing at a glance: Part 2 mucus secreting cells and mucous gland hypertrophy causing increased mucous volume, which becomes more viscous when It is infected, impairing the clearance of secretions (Figure 31.1). Te collection of stationary mucus acts as a conducive environment for bacteria to grow and this is the source of c Ebook Respiratory nursing at a glance: Part 2hronic infection.Chronic in fammation is stimulated by bacterial infection which causes further damage to the walls of the bronchi, this sets up a vicEbook Respiratory nursing at a glance: Part 2
ious cycle with progressive lung damage (figure 31.2). 1 e consequence for the patient is chronic respứalory trad infection with acute exacerbations, BronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. Reproduce Ebook Respiratory nursing at a glance: Part 2oms of an exacerbation of bronchiectasis?Patients experience an increased cough and sputum production that appears thicker and darker in colour. Other com mon symptoms arc wheeze, shortness of breath, chest tightness and or pain, haemoptysis. fever, sinusitis, rhinitis, poor appetite and malaise. Pa Ebook Respiratory nursing at a glance: Part 2tients ofcn describe profound tiredness which is always a feature of poor disease control. Most patients with bronchiectasis experience an infection tEbook Respiratory nursing at a glance: Part 2
wo to three limes a year which is usually relieved by a course of oral antibiotics. 1 or patients experiencing persistent respứatory infective symptomBronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. Reproduce Ebook Respiratory nursing at a glance: Part 2onfrmcd by high resolution computed tomography scan to assess hing structure. Additionally, other investigations maybe required: lung function fests: screening tests tor primary ciliary-dyskinesia (a relatively rare condition that affects lungs, sinuses and ears due to abnormal beating cilia): blood Ebook Respiratory nursing at a glance: Part 2 tests to screen for problems of immune function: skin prick tests lor allergy: sweat test/ blood tests (genetics) for cystic fbrosis: sputum examinatEbook Respiratory nursing at a glance: Part 2
ion for routine pathogens and fungi and prolonged cultures for slow growing mycobacteria: sputum cell count (neutrophils and eosinophils); physiotheraBronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. Reproduce Ebook Respiratory nursing at a glance: Part 2ist within the work-up is to obtain a nursing assessment of the patient’s lifestyle; measure exercise capacity and oxygenation (using the Shuttle'6 minute walk test and Borg breathlessness scale): report on quality of life (Chapter 22) and scheduling urgent and complex clinical reviews and hospital Ebook Respiratory nursing at a glance: Part 2admissions.Chapter 31 Bronchiectasis Causes and assocỉaIn developing countries, bronchiectasis is usually the result of damage by serious infections eEbook Respiratory nursing at a glance: Part 2
specially tuberculosis. Prevalence is higher in areas with poor standards of living, nutrition and sanitation and limited access to health services, aBronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. Reproduce Ebook Respiratory nursing at a glance: Part 2 Some patients are born with a weakness of the lungs’ innate defences (e g. cystic fbrosis). or de t'ciency in their body’s ability to fght infection (e.g. common variable immune defciency). which renders them prone to catching repeated respiratory infections and leads to bronchiectasis (Table 31 1 Ebook Respiratory nursing at a glance: Part 2>. Other patients are born with a normal host defence system but develop a severe infection (e g whooping cough or pneumonia) which damages the aữvvayEbook Respiratory nursing at a glance: Part 2
s and causes bronchiectasis.Prevalence1 e true prevalence rale may be underestimated Prevalence has I been estimated to be 3.7 4.2 per 100.000 (PasteuBronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. Reproduce Ebook Respiratory nursing at a glance: Part 2d Hubbard. 2010). T c prevalence of bronchiectasis in patients with chronic obstructive pulmonary disease (COPD) is high: 29% in primary care and 50% in hospital attendees (Pasteur el al.. 2010).Treatmentchest physiotherapy is the bedrock of bronchiectasis management (BIS ACPRC Guideline. 2009). Pat Ebook Respiratory nursing at a glance: Part 2ients should have periodic review s in then approach to using airway clearance techniques. Personalised techniques aim to remove secretions and reduceEbook Respiratory nursing at a glance: Part 2
the risk of an exacerbation: active cycle of breathing: autogenic drainage and device adjuncts, such as rhe aeapclla and futtcr.Bronchodilators and iBronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. Reproduce Ebook Respiratory nursing at a glance: Part 2use of steroid sprays or drops can help with post-nasal drip, runny nose and sinus pain as most patients with bronchiectasis develop chronic rhinosmusilis.Antibiotics are commonly used to combat respiratory infections. 1 e oral route is used to treat acute exacerbations: intravenous delivery is used Ebook Respiratory nursing at a glance: Part 2 when the oral route fails. Antibiotics can also be used continuously in patients with severe bronchiectasis to reduce bacterial load and therefore leEbook Respiratory nursing at a glance: Part 2
vel of in fam mation, and then the inhaled route is sometimes used. T e route of administration will depend on frequency and severity of the exacerbatBronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. Reproduce Ebook Respiratory nursing at a glance: Part 2.Surgery is considered an option for a few individuals who have localised bronchiectasis and experience frequent infective exacerbations.Further readingOzerovitch L. Wilson R. (2011) Managing bronchiectasis. Independent Nurse August 22:18-20.Wilson CB. Jones PW. O’Leary CJ. Cole PJ. Wilson R. (1997) Ebook Respiratory nursing at a glance: Part 2 Validation of the St Georges Respiratory Questionnaire in bronchiectasis. Am J Respir Crit Care Med 156: 536-541.■ I Pan 4 Respiratory diseasesBronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. ReproduceBronchiectasisTable 31.1 Underlying causes of bronchiectasisSource; sttaemark A. OÙérovitch L, VZilscn R. (2007) Rữif»f Med 101(6$: t163-70. ReproduceGọi ngay
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