Bronchial Dilation: A Case Study

Whitwell explained that bronchial dilation is characterized by the deficiency of elastin and disease advances by the destruction of muscle and cartilage. Due to the presence of lymphoid follicles in the bronchial wall, the inflammatory response occurs in the small airway. This inflammation causes the release of mediators such as proteases which in turn damage the large airway causing bronchial dilation. This further causes impaired mucus secretion which obstructs the airway due to retention of secretions. Inflammatory scarring replaces the lung functioning and causes bronchiectasis. The inflammation may spread beyond the airways and may cause interstitial pneumonia. The cells which cause inflammation in bronchiectasis are neutrophils, lymphocytes,
Expectorants: These medications help in clearing the mucus accumulated in the airways. These act by loosening the mucus and make it easy to cough-up. For example, Normal Saline, Mannitol, and acetylcysteine keep the airway hydrated and expels the mucus.
v. Bronchodilators: Bronchodilators relax the muscles surrounding the airways. These are used to treat bronchospasm and if the patient has very thick secretions. Inhaler or a nebulizer can be used to take bronchodilator medications. vi. Antimycobacterial antibiotics: are best to treat mycobacterial infections.
Nursing Management: -
1. Oxygen therapy: provide oxygen to the patient if there is difficulty in breathing and to raise the low-oxygen level.
2. Postural drainage: chest physiotherapy should be given to facilitate sputum production. Chest clapping is done by using both hands which help the mucus to move out of lungs.
3. Hydration: Drinking plenty of fluid especially water prevents mucus from becoming thick and sticky. Thus, facilitate easy cough-up.
4. Comfort: Provide a warm, quiet and comfortable environment to the patient to facilitate rest.
5. Mouth hygiene: Provide frequent mouth care to the patient in order to prevent foul-smell from the