Acute Bronchitis

Acute bronchitis is one of the five top reasons to seek medical care in the United States. The incidence of acute bronchitis is typically higher in fall and winter season, accounting for 82% of the cases (Fayyaz, 2014). It affects full spectrum of population including any age group, gender and demographics. The incidence of acute bronchitis accounts for 36 million office visits annually (Blush, 2013). Although it can be seen in variety of patients, children tend to get acute bronchitis as many 6 times a year where as adults acquire about two to four on average every year (Blush, 2013). These

The APN in collaboration with the MD will do a complete clinical evaluation of the patient. They will obtain patient medical history, perform physical exams, assess, and order blood test and CXR to rule out pneumonia, then provide appropriate treatment. The National Heart, Lung, and Blood Institute, NHLBI (2011) indicates that, since most cases of acute bronchitis are of viral etiology, no antibiotics are necessary. However, the antibiotics are used if the bacteria are suspected. The recommended treatment includes plenty of fluids to prevent dehydration that may be caused by fever, encourage enough rest and a good diet to facilitate recovery, cough suppressant such as dextromethorphan, and pain and fever reliever such as acetaminophen. The patient will be advised to use a humidifier or steam to help loosen mucus and relieve the symptoms and inhaled medication to keep airway open if wheezing. The patient will also be encouraged to quit smoking and avoid any source of airway irritants such as smoke and dust (NHLBI,

The World Health Organization (WHO) (2006A) defines COPD as a disease state characterized by airflow limitation that is not wholly reversible. The airflow limitation is usually both progressive and associated with abnormal inflammatory response of the lungs to noxious particles or gases. John's chronic bronchitis is defined, clinically, as the presence of a chronic productive cough for 3 months in each of 2 successive years, provided other causes of chronic cough have been ruled out. (Mannino, 2003). The British lung Foundation (BLF) (2005) announces that chronic bronchitis is the inflammation and eventual scarring of the lining of the bronchial tubes which is the explanation for John's dyspnea. The BLF (2005) believe that when the bronchi become inflamed less air is able to flow to and from the lungs and once the bronchial tubes have been irritated over a long period of time, excessive mucus is produced. This increased sputum results from an increase in the size and number of goblet cells (Jeffery, 2001) resulting in John's excessive mucus production. The lining of the bronchial tubes becomes thickened and an irritating cough develops, (Waugh & Grant 2004) which is an additional symptoms that john is experiencing.

Bronchiolitis is defined by the textbook as, “a diffuse, inflammatory obstruction in the small airways or bronchioles occurring most commonly in children” (Heuther & McCance, 2012). It is an acute inflammatory disease of the lower respiratory tract that occurs most commonly in infants and is caused by infection with seasonal viruses such as respiratory synctial virus (RSV) (Zorc & Hall, 2010). Bronchiolitis often results from an obstruction of the small airways. It is the leading cause of infant hospitalization in the United States (Zorc & Hall 2010) and is arguably the most common significant medical illness of childhood, with at least “1 in 7 normal infants developing symptomatic bronchiolitis in his or her first year of

Following the pathologic changes of chronic bronchitis and bronchiectasis, many patients will present with the following symptoms: shortness of breath, difficulty breathing, wheezing, productive cough and hemoptysis (Stauffer). Many of these symptoms will occur after the patient has recently contracted common cold viruses or other irritants as they weaken the body’s natural balance in the respiratory tract. With the majority of patients having a sudden increase of mucus production, this will have a tendency to obstruct the airways and prevent ventilation. In some cases the patient is able to clear the airway of the obstruction simply by coughing, but excessive coughing can lead to a much more problematic bronchospasm. Also, due to the weakened airway of bronchiectasis patients and increased thick sputum, coughing may prove to be vastly ineffective. These diseases are diagnosed with a combination of examinations such as Pulmonary Functions Tests (PFT), Chest

Chronic bronchitis: is the narrowing of the bronchi and bronchioles due to thickening of the airway walls and enlargement of mucus glands from chronic inflammation (Hogg, 2008). COPD caused by chronic bronchitis is characterized by excessive mucus production and expectoration, with mucus plugging contributing to obstruction of the bronchial tree,

Chronic Obstructive Pulmonary Disease (COPD) is a respiratory illness that progressively worsens over time. As seen in Mr. Adam’s case, symptoms include dyspnea, wheezing, and an occasional productive cough,.1 Emphysema and Chronic Bronchitis are the two main conditions of COPD, and can occur simultaneously in patients.1 Moreover, cigarette smoking or long-term exposure to environmental pollutants and chemical fumes can increase the likelihood of developing COPD. In emphysema, the alveoli are large and irregularly shaped due to a decrease in elastic fibers, which leads to decreased gas exchange.1,2 In chronic bronchitis, the bronchi are constantly inflamed and thick mucus make it difficult to breathe.

Approximately half of smokers with chronic bronchitis will stop coughing after one month of smoking cessation. Most patients will no longer cough with continued abstinence from smoking. “People with chronic bronchitis are prone to contracting influenza and Streptococcus pneumoniae infections.” If airflow obstruction has occurred this can improve but the improvement level depends on the duration of injury and the compliance with therapy. Obviously, the more impaired patients will have a lesser recovery of lung function. Conversely, those individuals that have continued bronchial irritation have only a fair to poor prognosis, since repeated fight with the disease usually get worse, with affected individuals having more frequent incidents of coughing and dyspnea over time and further progression of lung function abnormalities. The overall 10 year mortality rate following the diagnose of chronic bronchitis is 50 percent, with respiratory failure following an acute exacerbation being the most frequent terminal event. Such acute exacerbation, are often precipitated by bacterial infection, manifested by purulent sputum, fever and a worsening of the symptoms of poor ventilation. Other known precipitants

Etiology of acute bronchitis include airway edema, airway wall thickening, excess mucus production and loss of ciliary function resultsource. Airflow is obstructed during both inspiration and expirations. Widespread bronchial narrowing with mucus plugging produces hypoxemia because of the mismatching of ventilation and perfusion (Papadakis et al., 2015). The most common presenting symptoms is dyspnea on exertion which usually develops late in the course of the disease. Lungs are diminished and crackles are more common than wheezes. The

Bronchitis is a viral infection that can last from six weeks – two years. This virus infects the main airway of the lungs, which is known as your bronchi, causing them to become irritated or inflamed. The walls of the bronchi produces mucus to trap dust and other particles that could cause the irritation, in most cases of bronchitis the infection irritates and inflames the bronchi causing them to produce MORE mucus than normal, which the body tries to shift through by coughing.

Patient F.F. is a 75-year-old female that arrived to the emergency room and admitted to the floor for left lobe pneumonia from an exacerbation from chronic obstructive pulmonary disease, or COPD. Upon my assessment, the patient was short of breath and required 2 liters of oxygen by nasal cannula to prevent use of accessory muscles and loss of breath. Wheezes were present in the lower lobes of the lungs and breath sounds were diminished. The patient’s oxygen level was 95% on 2 liters of oxygen, but once the oxygen was removed, the oxygen level would drop down to 88%. A productive cough was present with green sputum. The patient reported feeling ‘weak’ and ‘unable to get around like [she] used to.’

The SP-16 cohort struggled with the interpretation of lung auscultation findings in the general exam PEP, missing a diagnosis of bronchitis. Many misdiagnosed pneumonia, resulting in the recommendation of unnecessary imaging and/or referral for antibiotics.

Encompassed primarily by two conditions, emphysema and chronic bronchitis, Chronic Obstructive Pulmonary Disease (COPD) refers to a group of diseases of a debilitating and progressive nature that cause inflammation of the airway and interferes with the ability to breathe (National Heart, Lung, and Blood Institute [NHLBI], 2013). The diseases in COPD have some shared characteristics, including a progressive and irreversible limitation of the airflow associated with an abnormal inflammation of the peripheral bronchioles and considerable damage to lung parenchyma (NHLBI, 2013). In the United States (US), there are approximately 15.7 million adults diagnosed with COPD, although estimates suggest that these figures are higher

Chronic lung diseases affect millions of individual’s in all age groups across the United States. Breathing is a necessary function to life but to people that suffer from respiratory illnesses it is a precious gift that many individuals do not consider & may take for granted. Many factors can determine an individual’s susceptibility to illness including genetics, and the lifestyle choices that are made such as smoking; along with the environmental conditions where we live, work or play. Asthma, a chronic lung disease, has affected approximately 25 million people in America of which 7 million are children. It causes a narrowing and an inflammation process to occur which results in a tightness in the chest, wheezing, and shortness of breath with repeated coughing episodes.

As shown in Figure 4, COPD can partake to two unique forms having their own devastating effects as portrayed within the flow chart. In chronic bronchitis cases, COPD may begin with some damage to the endothelium which can inhibit the musociliary response that is in charge of removing bacteria and mucous. This is a sign of mucous gland hyperplasia (sputum production), a hallmark symptom of chronic bronchitis. This is where patients may first notice sputum coughing as a symptom of bronchitis. This also causes inflammation and obstructs the airways. The airway lumen may also fill with neutrophilia, and neutrophilic infiltrates build up in the submucosa. The respiratory bronchioles become inflamed and blockages are caused by smooth muscle hyperplasia,