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Presenter  Andrea Fagan

3rd year Student Nurse

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`  At the end of this presentation fellow students will:

` Know what cause bronchial obstruction

` Types of bronchial obstruction

` View bronchial obstruction in 3 diseases condition` Diagnostic test use

` Treatment

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` Is obstruction of the airway and the alveoli.

` Bronchial obstruction, can be temporary or prolonged. It is a universal pathologic occurrence;it is common among the newborn; it affectseveryone many times later in life, and it iscommonly the terminal phase in slow deaths fromany cause. Only the cough reflex prevents us allfrom drowning in our own secretions. Only the

cough reflex prevents extermination of the humanrace by bronchial obstruction.

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` The power of bronchial obstruction to cause

bronchial and pulmonary disease is threefold. It

acts as a primary, a predisposing and a

perpetuating factor.

3 Types of bronchial obstruction

Bypass valve : is the result of a partial

obstruction which allow air to enter the bronchusand its sign is wheezing.

check valve : the lumen of the bronchus

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enlarges on inspiration allowing air , but decreases

on expiration and refuses exit to air and gradually

accumulates and cause localizes emphysema.

Stop -valve : this is the reverse of the check

valve. Air cannot get into the lobe supplied by the

obstructed bronchus, while it might or not escape,

which result in collapse of the lobe. (Chevalier Jackson 91934)

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` Pulmonary secretions

` Foreign body

` Bronchogenic carcinoma

`  Aspiration` Metastatic tumour 

`  Asthma

` COPD

` Bronchietctasis

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` Trachea stenosis

` Bronchial stenosis

Enlarged lymph nodes

Tuberculosis` Lung collapse

` Lung fibrosis

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` Signs and symptoms would be the signs and

symptoms of each individual disease.

` Bronchiectasis

` Bronchiectasis is an irreversible widening (dilation)

of portions of the breathing tubes or airways

(bronchi) resulting from damage to the airway wall.

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understanding Bronchiectasis

` In bronchiectasis, mucus production increases,

the cilia are destroyed or damaged, and areas of the bronchial wall become chronically inflamed

and are destroyed.

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` Bronchogenic carcinoma is a malignant neoplasm

of the lung arising from the epithelium of the

bronchus or bronchiole.

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` COPD, or chronic obstructive pulmonary (PULL-

mun-ary) disease, is a progressive disease that

makes it hard to breathe. "Progressive" means the

disease gets worse over time` COPD can cause coughing that produces large

amounts of mucus (a slimy substance), wheezing,

shortness of breath, chest tightness, and other 

symptoms.

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` Lung Function Tests

Spirometry

` Chest x-ray

` Computer tomography scan (CT scan)

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` Treatment for bronchial obstruction is dependent

on which of the condition the patient has. For 

example if the patient has COPD then the required

treatment would focus on;` Lifestyle changes : which would help the patient

feel better and stay more active and slow the

progression of disease that cause bronchial

obstruction.

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`  Assess respiratory rate and depth by listening to

lung sounds. Respiratory rate and rhythm

changes are early warning signs of impending

respiratory difficulties`  Assess for dyspnea and quantify (e.g., note how

many words per breath patient can say); relate

dyspnea to precipitating factors.

`  Assess for dyspnea at rest versus activity andnote changes. Dyspnea that occurs with activity

may indicate activity intolerance

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` Monitor breathing patterns: Bradypnea (slow respirations)

Tachypnea (increase in respiratory rate)

Hyperventilation (increase in respiratory rate or tidalvolume, or both)

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` Position patient with proper body alignment for 

optimal breathing pattern. If not contraindicated,

a sitting position allows for good lung

excursion and chest expansion.` Ensure that oxygen delivery system is applied to

the patient. The appropriate amount of oxygen

is continuously delivered so that the patient

does not desaturate.

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`  An oxygen saturation of 90% or greater should be

maintained. This provides for adequate

oxygenation.

` Maintain a clear airway by encouraging patient toclear own secretions with effective coughing. If 

secretions cannot be cleared, suction as needed

to clear secretions

` Pace and schedule activities providing adequaterest periods. This prevents dyspnea resulting

from fatigue

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` Provide reassurance and allay anxiety by staying

with patient during acute episodes of respiratory

distress. Air hunger can produce an extremely

anxious state.` Encourage diaphragmatic breathing for patient

with chronic disease

` Explain all procedures before performing. This

decreases patient¶s anxiety

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` Explain use of oxygen therapy, including the type

and use of equipment and why its maintenance is

important. Ratio Issues related to home oxygen

use, storage, and precautions need to beaddressed

` Instruct about medications: indications, dosage,

frequency, and potential side effects. Include

review of metered-dose inhaler and nebulizer treatments, as appropriate

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` Medicines

` Bronchodilators: relax the muscles around your 

airways. This helps open your airways and makesbreathing easier.

` Inhaled Glucocorticosteroids (Steroids):

Inhaled steroids are used to treat people with

COPD symptoms and may reduce airwayinflammation.

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` Oxygen Therapy

` If you have severe COPD and low levels of 

oxygen in your blood, oxygen therapy can help

you breathe better. For this treatment, you're givenoxygen through nasal prongs or a mask.

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Causes of bronchial obstructionhttp://symptoms.wrongdiagnosis.com. retrieved

October 9 th,2010

` http://www.bronchogeniccarcinoma.com/retrievedOctober 10th, 2010

` Localized emphysema as a sign of incomplete

bronchial obstructionhttp://www.jstor.org/pss/20315976 retrieved

October13th 2010

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` http://www1.us.elsevierhealth.com/MERLIN/Gulani

ck/Constructor/index.cfm?plan=08#TINT retrieved

October 13th2010.

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` Please to ask any question?