Introduction
Bronchitis can be defined as the inflammation of the bronchi, which are the breathing tubes or the airways (Jarhyan et al, 2022). The condition causes excessive production of mucus and further changes. Different kinds of bronchitis exist, but chronic and acute bronchitis is the most common. Chronic bronchitis is long-standing swelling of the breathing tubes. Generally, it is common with active smokers. According to Jarhyan et al (2022), individuals suffering from chronic bronchitis tend to have lung diseases more easily. Also, they possess incidents of acute bronchitis if the symptoms get worse.
Nursing Assessment
For someone to be categorized as having chronic bronchitis, they should have a cough and mucus for a while, for instance, three months at least annually for two consecutive years (Punchamannil, 2022). Also, some causes of symptoms like lung infections such as tuberculosis should be ruled out. Furthermore, individuals with chronic bronchitis suffer from chronic obstructive pulmonary disease. Bacteria or viruses do not cause chronic bronchitis. Various specialists approve that the chief cause of chronic bronchitis is tobacco smoking. Also, air pollution and personal work environment can play a role; however, it is mostly true when someone smoke.
Punchamannil (2022) explains that the majority of chronic bronchitis symptoms that may appear include cough, sometimes known as smoker’s cough, making mucus cough (expectoration), wheezing and soreness in the chest. However, each person’s symptoms could be a little bit unique. Before they experience shortness of breath, people with chronic bronchitis frequently have a cough and produce mucus for years. Additionally, Uslu and Canbolat (2022) claim that disability, frequent and severe infections that impact the airways, bronchial tube narrowing and obstruction, and breathing difficulties are all potential effects of chronic bronchitis. Other symptoms could include heart failure, bluish fingernails, lips, and skin from low oxygen levels, as well as wheezing and crackling sounds when inhaling. Chronic bronchitis symptoms can resemble those of other lung illnesses or health issues. Consult with your doctor to get a diagnosis.
Diagnosis
The nurse may take a complete health background and perform different diagnoses, such as pulmonary function tests (Gupta, 2022). These examinations aid in determining how well the lungs can carry air into and out of the body. The specific machines that patients breathe into are frequently used to conduct the testing. They might include a spirometry test, which measures lung function using a spirometer instrument. It is among the easiest and most often used pulmonary function tests. It might be employed to monitor a lung condition, determine the lungs’ health, and assess the effectiveness of treatment. Also, it can be used to determine the severity of the lung disease and whether it is restrictive or obstructive. Less air will enter the lungs if anything is restrictive. Obstructive means that fewer breaths will leave the lungs.
On the other hand, Gupta (2022) clarifies that the Peak flow monitor test determines how quickly someone can exhale air from the lungs. The major bronchi in the lungs get narrowed by inflammation and mucus, so air leaving the lungs moves more slowly. A peak flow monitor can be used to measure it. The assessment is crucial for determining how effectively the disease is being managed.
Another way chronic bronchitis can be diagnosed is by pulse oximetry (Alani et al, 2022). A molecule called haemoglobin, found in the red blood cells, carries oxygen. The amount of oxygen the blood’s haemoglobin is transporting is measured by pulse oximetry. It is a percentage known as oxygen saturation (scored out of 100). The test, which utilizes a sensor put on the fingertip or earlobe, is straightforward and painless. Pulse oximetry can help determine whether there is a problem since people with lung conditions may have lower blood oxygen levels than usual. The likelihood of an issue with oxygen uptake increases with the degree of lung damage. The severity of a person’s pulmonary impairment can also be assessed using pulse oximetry. According to Alani et al (2022), how much light is taken in by the blood is determined by a pulse oximeter. It reveals how much oxygen is present in the blood. It projects two red and one infrared light through the earlobe or fingertip. Oxygen-rich blood absorbs more infrared light while allowing more red light to flow. Blood with insufficient oxygen allows more infrared light to flow while absorbing more red light. The blood cells will appear bluer if they are deoxygenated.
Thirdly, a Chest X-ray can diagnose chronic bronchitis as it creates photos of the internal tissues, organs, and bones, including the lungs. Chest x-rays are typically not prescribed for the diagnosis of chronic bronchitis. However, they are frequently requested to rule out other causes of dyspnea and a productive cough, such as pneumonia and heart failure. It is helpful to investigate diseases other than the chronic obstructive pulmonary disease that might be the origin of the patient’s symptoms because X-ray findings are neither sensitive nor specific for chronic bronchitis.
Specific, Realistic, Measurable patient Goals
Following Murphy (2022), setting goals might also help someone with chronic bronchitis manage their condition. Setting goals can help people with chronic bronchitis have happier, healthier lives by assisting them in creating better behaviours linked to their physical, social, and mental health. Doctors frequently advise their chronic obstructive pulmonary disease patients to set objectives for healthy lifestyle changes like decreasing weight, increasing their physical activity, or stopping smoking. It can significantly impact overall symptoms, physical stamina, and the risk for serious health issues when a person can push themselves to attain those goals.
Goal-setting is a process for identifying long-term desires and needs and decomposing them into manageable tasks. It is a helpful framework for translating thoughts into realistic objectives that a person can achieve. The goal-setting process compels individuals to consider their objectives from new angles and develop tactics for moving forward. It also stimulates individuals to take action by serving as a guide to achieving their goals.
According to Murphy (2022), being specific about what you intend to accomplish is crucial. Vague words and overarching concepts will not change anything; one needs a particular aim that explains what they are striving towards. Secondly, the objective must be quantifiable, meaning it must be constrained by specific standards that inform the person when the goal has been attained. One must be concise and to the point about the end aim to accomplish this. Moreover, some objectives are simply unrealistic. Setting a goal you know you shall not be capable of fulfilling can only lead to failure and disappointment. Furthermore, it is important to keep the objectives narrowly defined and pertinent to the things one desires. To put it another way, one wants to ensure that goals make sense and that they can help them get where they need to go.
Nursing interventions
Nursing interventions for chronic bronchitis include monitoring for severe effects of bronchodilators-tremulousness, cardiac arrhythmias, tachycardia, CNS stimulation, and high blood pressure (Punchamannil, 2022). Also, check on oxygen saturation at repose and with action, and remove all irritants to the lungs, including smoking- typically, quitting smoking lowers coughing, mucus secretion, and pulmonary irritation. As much as possible, keep the patient’s room dust-free. Additionally, adopt postural drainage positions to aid in the removal of secretions that cause airway obstruction.
Additionally, Uslu and Canbolat (2022) explain that nursing intervention encompasses teaching controlled coughing and promoting a high fluid intake like 2–2.5 L daily while maintaining a healthy level of cardiac reserve. In humidifying the bronchial tree and liquefying the sputum, nurses can administer inhalations of nebulized saline. Add moisture to the air inside. When more mucus is present, the patient is advised to adopt a comfortable position to lessen dyspnea and avoid dairy products if these cause sputum output to increase.
Moreover, the nurse can utilize pursed lip breathing occasionally and during episodes of dyspnea to regulate breathing rate and depth and to enhance respiratory muscle coordination. Pursed lip breathing is a respiratory technique meant to increase the effectiveness of the breaths by slowing them down and making them more deliberate. After inhaling, one accomplishes this by pouting the lips and exhaling through them slowly, deliberately, and frequently to a count.
Another nursing intervention is discussing and exhibiting relaxation aerobics to lessen stress, worry, and nervousness. Also, when the patient has dyspnea, encourage frequent, little meals because even a small increase in belly contents can strain the diaphragm and make breathing difficult. Besides, providing dietary supplements in liquid form increases calorie intake and prevents weight loss. They are avoiding foods that cause stomach pain and inspiring the patient to practice energy-saving strategies and support using a portable oxygen system for individuals with hypoxemia and evident impairment.
Finally, by calming down and widening the bronchial passageways in the lungs, bronchodilator medicines can help to ease the symptoms of chronic bronchitis. Steroids Steroids, when inhaled as an aerosol spray, can aid in the relief of chronic bronchitis symptoms. They are frequently used to treat long-term chronic bronchitis that may cause the airways to constrict and swell.
In conclusion, to be diagnosed with chronic bronchitis, which affects the airways, one must have a cough and sputum production for at least three months in each of the previous two years. The goblet cells and mucus-secreting glands produce sputum when pollutants or allergens irritate the airways. Acute bronchitis episodes can result from various viral, bacterial, and mycoplasmal illnesses. The condition of chronic bronchitis is ongoing; smokers who continue to smoke risk developing COPD, emphysema, and worsening symptoms. Each of these ailments poses a threat to life.
References
Alani, S. S., Stierwalt, J., LaPointe, L. L., Morris, R. J., Jeong, A. C., Moses, J. F., & Upton, T. D. (2022, March). An Investigation of Pulse Oximetry Levels during Swallowing in Healthy Adults and in Individuals with Severe and Very Severe Chronic Obstructive Pulmonary Disease. In Seminars in speech and language. Thieme Medical Publishers, Inc.
Gupta, S. (2022). Diagnosing asthma and chronic obstructive pulmonary disease: Importance of pulmonary function testing. Canadian Family Physician, 68(6), 441.
Jarhyan, P., Hutchinson, A., Khaw, D., Prabhakaran, D., & Mohan, S. (2022). Prevalence of chronic obstructive pulmonary disease and chronic bronchitis in eight countries: a systematic review and meta-analysis. Bulletin of the World Health Organization, 100(3), 216.
Murphy, J. L. (2022). Prevention, identification and management of malnutrition in older people in the community. Nursing Standard.
Punchamannil, J. M. (2022). Care of the Patient with Chronic Obstructive Pulmonary Disorder. Medsurg Nursing, 31(3), 198-199.
Uslu, A., & Canbolat, Ö. (2022). Nursing Care of The Chronic Obstructive Pulmonary Disease Patient According to Orem’s Theory of Self-Care Deficiency: A Case Report. Journal of Education and Research in Nursing, 19(2).
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