Question

1. Howard Long, 50 years of age, is a male patient diagnosed with bronchiectasis. He has smoked 1 pack per day of cigarettes for 35 years. He has a long history of recurrent bronchial infections. He has a chronic productive cough with copious amounts of purulent sputum. The patient complains that he is short of breath even at rest. He has clubbing of his fingers. The chest CT scan reveals bronchial dilation. (Learning Objectives 5 and 6)

1. How should the nurse explain to the patient and family the pathophysiology of bronchiectasis as it is related to the symptoms the patient is experiencing? (3.33 points)

2. How should the nurse explain to the patient and family the goals of medical management that may be used to treat the bronchiectasis? (3.33 points)

3. What does the nursing management for bronchiectasis entail? (3.33 points)

Answer 1

1)
After some time as an individual has repeated pulomanry diseases or substances that bother the bronchi (the enormous aviation routes used to inhale), the irritation harms the bronchial wall . The bronchial wall as it is harmed loses its supporting structure and the outcome is thick sputum that can without much of a stretch deter the bronchi. The wall become for all time widened and change shape, which makes it hard to clear bodily fluid from the lungs. The body's hack reflex is utilized when there is irritation in the aviation route, for example, discharges. There is a lot of thick bodily fluid created every day, which clarifies the perpetual hack endeavoring to remove the bothering from the aviation routes. Maintenance of a portion of the discharges and the subsequent obstruction reason the alveoli (the little aviation routes where oxygen and carbon dioxide are traded) to fall so that there is less surface territory in the lung to get the oxygen required and dispose of the waste result of carbon dioxide. Scar tissue replaces the once working lung tissue. The diminishing in working lung tissue prompts the respiratory framework being inadequate to address the body's issues, which prompts shortness of breath even while very still. The emissions will in general pool into a fragment or lower flaps of the lungs and microscopic organisms can develop in the discharges prompting incessant diseases and the sputum ends up purulent (changes shading and grabs a smell). There is no known explicit reason for clubbing of the fingers, however it is seen with different lung sicknesses, including bronchiectasis.

2)
The objectives of the therapeutic administration for bronchiectasis include:

•   Promote bronchial waste and clear emissions from territories of the lung that are influenced:

o   Chest physiotherapy and postural waste.

o   Bronchoscopy to evacuate purulent sputum, if necessary.

•   Prevent or control diseases as ahead of schedule as could reasonably be expected:

o   Annual flu immunization.

o   Pneumococcal immunization, and rehash the antibody once in 5 years.

o   Report indications of a contamination including fever, chills, or purulent bodily fluid when it grows so the doctor may arrange anti-microbials to treat bacterial diseases. A few doctors will arrange anti-infection agents for the winter to diminish intermittent diseases, and a few doctors keep the patient on various anti-toxins at various interims throughout the entire year to control the contamination, if vital.

•   Smoking discontinuance is educated in light of the fact that smoking anticipates legitimate waste with respect to the bronchi by deadening the cilia small hairs that line the respiratory tract and are utilized to help push bodily fluid and discharges from the lung into the mouth. Smoking likewise builds discharge creation and chafes the bodily fluid films that line the whole aviation route framework, Smoking causes the giblet cells (that make the bodily fluid) to extend and make more bodily fluid.
3)
•   Provide manifestation help and solace measures.

•   Promote aspiratory latrine.

•   Assess nourishing status and create persistent centered systems to advance satisfactory sustenance:

o   Six little dinners every day.

o   Liquid high protein shakes invigorated with nutrients and minerals when vitality level is diminished.

o   Weigh quiet at same time of day and report a diminishing of weight of multiple pounds inside a 24-hour duration.

o   Collaborate with the doctor for a dietician counsel to support patient and family with supper arranging.

•   Instruct understanding on smoking suspension and give follow-up on endeavors to stop:

•   Instruct patient and family on the best way to do postural seepage and percussion.

•   Instruct patient and family on procedures to monitor vitality while advancing as dynamic of an actual existence as could be expected under the circumstances:

o   Make a rundown of exercises that should be done and organize the exercise and figure out which exercises can be appointed to relatives.

o   Take rest breaks in the middle of exercises for the duration of the day. Decide when the most noteworthy vitality level is and do the exercises that are most significant amid that timeframe.

o   Sit at whatever point conceivable to perform exercises to moderate vitality.

o   Collaborate with the doctor for an aspiratory recovery counsel.

•   Instruct patient and family on approaches to diminish hazard for a disease:

o   Demonstrate appropriate strategy for hand washing and have patient and family return the show.

o   Avoid people with an upper respiratory disease or different contaminations.

o   Instruct on legitimate approach to discard emissions.

o   Instruct on the signs and manifestations of a disease to answer to the doctor immediately with the goal that early treatment might be acquired. (Fever, change in shading or scent of sputum ought to be accounted for).

•   Instruct patient and family to stay away from air contaminations that can chafe the aviation route and lead to compounding of the side effects:

o   Avoid used smoke.

o   Avoid pressurized canned products.

o   Avoid going outside when the air quality list is poor or the dust tally or form tally is high.

•   Provide passionate help to the patient and family through:

o   Active tuning in.

o   Providing contact data for the American Lung Association bolster gathering.

o   Collaboration with doctor to get extra help through psychosocial guiding.

Hope you find this helpful thankyou ☺️?