CHAPTER 2 Respiratory System^99
Bronchiectasis
WHAT WENT WRONG?
Bronchi and bronchioles become abnormally and permanently dilated, caused by
infection and inflammation. This results in excessive production of mucous that
obstructs the bronchi. There is some obstruction of the airways and a chronic
infection. The changes within the lung can be localized or generalized. The lung
may develop areas of atelectasis where thick mucous obstructs the smaller air-
ways, making the mucous difficult to expel. This results in inflammation and
infection of the airways and leads to bronchiectasis.
PROGNOSIS
Early diagnosis and appropriate treatment of infections are essential for manage-
ment. Postural drainage and chest physical therapy aid in movement of mucous
from the airways. The difficulty in breathing is caused by excess mucus similar to
patients with Chronic Obstructive Pulmonary Disease (COPD) (emphysema or
chronic bronchitis).
HALLMARK SIGNS AND SYMPTOMS
- Difficult breathing (dyspnea) due to the mucous production and irritation
within the airways. - Productive, foul-smelling odorous cough, due to thick, difficult-to-expel,
tenacious mucous, often with bacterial colonization. - Cough may be worse when lying down.
- Recurrent bronchial infections.
- Hemoptysis (blood-tinged or bloody mucous).
- Loss of weight because patients are not eating well, due to respiratory
changes and foul-smelling mucous with cough. Increased respiratory effort
requires more calories to meet normal requirements. - Crackles or rhonchi on inspiration due to mucous build-up.
- Anemia of chronic disease.
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