Etiologic factors

• Cigarette Smoking
• Environmental factors
• Occupational factors
• Alpha1-antitrypsin Deficiency
• Infection
• Aging
Chronic Bronchitis
• excessive production of mucus in the
bronchi accompanied by a recurrent
cough

• persists for at least 3 months of the

year during at least 2 successive years
Pathologic changes
(1) hyperplasia of mucous-secreting
glands in the trachea and bronchi
(2) increase in goblet cells
(3) disappearance of cilia
(4) chronic inflammatory changes and
narrowing of small airways
(5) altered function of alveolar
macrophages
Clinical Manifestations
EMPHYSEMA
PATHOPHYSIOLOGY

FIGURE 3
CLINICAL MANIFESTATION
FIGURE 1
FIGURE 2
ASTHMA
• PATHOPHYSIOLOGY
CLINICAL MANIFESTATION
• Cough
• Dyspnea
• Wheezing
COMPARISON….
Assessment and Diagnostic Evaluation

• Physical Examination
• Spirometry
• Arterial Blood Gases (ABGs)
• Chest X-ray
• Sputum Culture
• Pulse Oximetry
Complications
• Acute Respiratory Failure
• Cor pulmonale
• Acute exacerbations of Chronic
Bronchitis
• Pneumonia
Medical Management
• Smoking Cessation
• Pharmacologic Therapy
1) Bronchodilators
2 ) Corticosteroids
3 ) Alpha1- Antitrypsin
• Oxygen Therapy
• Surgical Management
Surgical Management
• lung volume reduction surgery (LVRS).
• lung transplantation
Nursing Interventions
a. Promoting Smoking Cessation

Expected Outcomes: verbalizes willingness/interest to quit smoking

, verbalizes information about smoking, risks of continuing,
benefits of quitting, and techniques to optimize cessation efforts
Improving Gas Exchange
• Expected Outcomes : PaCO2 of 35-45 mmHg, return
to normal PaO2 to normal range, and improve mental
status
Achieving Airway Clearance
• Expected Outcomes: Normal breath sounds ,
patent airway, and effective coughing
technique
Improving Breathing Pattern
• Expected Outcomes: demonstrate effective breathing
pattern, use of controlled breathing techniques
(pursed-lip breathing) and diaphragmatic breathing
(abdominal muscle breathing), demonstrate
respiratory rate within near-normal limits
Improving Activity Intolerance
• Expected Outcomes: Improved activity tolerance by
maintaining a realistic activity level and
demonstrating energy conservation techniques
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