Chronic Bronchitis Case Study

Acute bronchitis is one of the most common diagnoses encountered in a primary care setting. It affects millions of individuals resulting in significant impact on health of patients and health care industry. Studies have shown that 90% of times acute bronchitis is caused by a virus, yet health care providers are failing to treat or manage these patients with appropriate therapies (Knutson & Braun, 2002). The focus of this paper is to review the guidelines for treatment of acute bronchitis after differentiating acute bronchitis from other common respiratory disease in terms of epidemiology, pathophysiology, clinical features, diagnosis, differential diagnosis, complications and patient education. Understanding the evaluation and treatment guidelines, nurse practitioners can provide evidence-based practice for patients with acute bronchitis.

An ongoing cough or a cough that produces large amounts of mucus (often called "smoker's cough")

EH is a 68-year-old male who comes into the clinic complaining of a fever with a temperature of 103 °F. He has had a cough for the last three days that is producing some thick green brown mucous. The MD feels he most likely has bacterial pneumonia. He also has a history of having rheumatoid arthritis, and being immune compromised as he is on an immunosuppressant methotrexate. He has noted that over the last year he has lost weight unintentionally and feels he is underweight.

Bronchitis is the inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs. The thin mucus lining of these airways can become irritated and swollen; the cells that make up the lining may leak fluids in response to the inflammation. Bronchitis most often occurs during the cold and flu season usually coupled with an upper respiratory infection. Bronchitis can be divided into two categories: acute or chronic each of which has distinct etiologies, pathologies, and therapies. I chose this condition because it seemed like an interesting topic to research on, and I am also interested in learning more

D.Z.is a 65-year-old man admitted to medical ward with an exacerbation of chronic obstructive pulmonary disease (COPD; emphysema). Past medical history (PMH) indicates hypertension (HTN), well managed with enalapril (Vasotec) past six years, diagnosis (Dx) of pneumonia yearly for the past three years. D.Z. appears cachectic with difficulty breathing at rest. Patient reports productive cough with thick yellow-green sputum. He seems anxious and irritable during subjective data collection. He states, he has been a 2-pack-a-day smoker for 38 years. He complains of (c/o) insomnia and

Another Consultation Report dated 12/06/2016, indicated that the claimant presented with exacerbation of COPD, acute bronchitis, and pseudomonas aeruginosa. The CT scan of the chest revealed bilateral lower lobe atelectatic changes, fibrosis, and a small 1 cm left lower lobe nodular density. A pulmonary consultation was recommended. His blood pressure was 142/79 mmHg. The physical examination revealed bilateral decreased breath sounds and scattered wheezes. His glucose was 189. DuoNeb, IV Solu-Medrol, and IV antibiotics were prescribed.

History of Present Illness: Ms. Manock is a very pleasant 60-year-old woman with a history of severe COPD. She was previously seen by Elvira Aguila, MD. Her last office visit was in February 2015. Since that time, she states that over the last few weeks, she feels her dyspnea has worsened which is a result of increased humidity, which is normal for her. She has had a stable cough over the last six months, which is intermittently productive of sputum. She is using her supplemental oxygen at 2 L/minute with exertion and with sleep. She also notes postnasal drip, which is related to seasonal allergies.

History of Present Illness: Ms. Babula is a very pleasant 76-year-old woman who was previously seen in this office by Elvira Aguila, MD for moderate COPD by pulmonary function testing in 2010. She is currently on monotherapy with Atrovent p.r.n. and she has not used her bronchodilators for quite some time. She does have some stable dyspnea on exertion, which does not limit any of her activities. She does take care of an 18-month-old child as well. She denies any cough, though she does feel that she has some chest congestion in the morning. She denies any chest pain or wheezing.

For this paper, I decided to write about bronchiectasis. Bronchiectasis is a respiratory disease that takes on the appearance of cystic fibrosis. It is caused by the buildup of mucous causing the airways to stretch and widen and are irreversible. (American Lung Association, 2015) I chose to write about bronchiectasis because one of my dear friends has recently been diagnosed with this respiratory disease. Jasmine Coleman was born with a rare blood disorder and as a child she was always in and out of the hospital because she was more susceptible to infections, pneumonia was the main problem. Her condition was so severe that she wasn’t expected to have lived through high school, but she is still with us today. Over time her airways have built up with mucous and she began to cough up large amounts of blood. She had undergone various testing and treatments to try to figure out what was wrong. It was only recently when she was finally diagnosed with bronchiectasis. She has only 22 percent lung function and that is mainly in her left lung for her right lung is filled with blood. She is currently on six liters of oxygen when she is out and about and two liters for when she is resting. (Times Bulletin, 2015) She may be

Chronic Bronchitis is formed when the bronchial tubes become inflamed. The bronchioles become inflamed when hypersecretion of mucus occurs. This hypersecretion isn’t being prevented due to the cilia being damaged. When excess mucus is formed it creates an obstruction in the bronchial tubes that lead to the lungs (Kim, 2013). This can occur if the patient has Chronic Obstructive Pulmonary disease, is a smoker, or a factory worker that is exposed to irritants on a daily basis (American Lung Association, 2015). Research has also

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

Bronchiectasis is a chronic condition of the airways in which the lungs become ineffective at clearing out mucus. Oftentimes, the condition is brought on by another disease or infection that cause the airways to weaken, widen, or become flabby and scarred. The presence of mucus inside the airways can result in the production of infectious bacteria and a possibly fatal infection (Sutton 257). Currently, a single or double lung transplant is the only way to cure bronchiectasis (BE for short), but transplants of major organs can cause many complications – sometimes creating even more problems than they solve – and transplants are not very easily obtainable (What Is…?). Though there is still no true cure for bronchiectasis, research has discovered new advances that aid in the therapy of the condition, including mucoactive, anti-inflammatory, and antibacterial therapy, all of which contribute toward a more efficient and more easily procurable means of treatment.

Bronchitis COPD is a productive cough for at least 3 months along with airway obstruction. This condition would likely result in the clinical finding of crackles, wheezing, sputum production, and hypoxia and abnormally elevated carbon dioxide retention at rest. Bronchitis COPD involves inflamed airways obstructed by mucus whereas emphysematous COPD involves destruction of terminal airways leading to decreased space for gas exchange. In emphysematous COPD, one would have shortness of breath, dyspnea and may appear barrel chested. Also, hypoxia and hypercarbia aren’t as prominent in emphysematous COPD as in bronchitis COPD.

“Bronchitis” is an inflammation that affects the lungs, “broncho” meaning lungs, “itis” meaning inflammation of an organ. Bronchitis comes in two types, Acute and Chronic bronchitis. Acute Bronchitis is an infection that also occurs to the bronchial tubes, which gets swollen. It is usually caused by a virus however, lasts for about 2 to 3 weeks. This commonly happens after someone had a cold or flu. It only happens for a short period of time. Chronic bronchitis is the inflammation of the lungs that affects the respiratory system. The airways that transport air to our lungs are called the bronchial tubes and when those tubes are inflamed, little air travels to the lungs or vice versa. As a result mucus starts to build up in the respiratory organs which causes people to breath less air/oxygen into their lungs since the bronchial tubes play a role in the act of breathing. It is an ongoing illness that needs medical attention and can last up to 2 years. In the early stage of the disease the airway is only affect but when the disease progresses the whole lungs (bronchial tree) is affected. Chronic Bronchitis is one of the two conditions of Chronic obstructive pulmonary disease (COPD) and emphysema is the other. If a person have both these conditions then they are said to have COPD. Cilia are like filters and are not just found in the nose but, also in the air passage to prevent substance from going in the lungs. Smokers have a higher chance and are one of the main reason of