Chronic Bronchitis Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your

lungs. Bronchitis may be either acute or chronic. Often developing from a cold or other respiratory infection, acute bronchitis is very common. Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking. Acute bronchitis usually improves within a few days without lasting effects, although you may continue to cough for weeks. However, if you have repeated bouts of bronchitis, you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD). Treatment for bronchitis focuses on relieving your symptoms and easing your breathing. Symptoms: For either acute bronchitis or chronic bronchitis, signs and symptoms may include: Cough Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color Fatigue Slight fever and chills Chest discomfort

If you have acute bronchitis, you may have a nagging cough that lingers for several weeks after the bronchitis resolves. Chronic bronchitis is defined as a productive cough that lasts at least three months for two consecutive years. If you have chronic bronchitis, you're likely to have periods when your signs and symptoms worsen. At those times, you may have acute bronchitis on top of your chronic bronchitis. In some cases, the cough may disappear only to reappear later. When to See your doctor if your cough: see a doctor

Lasts more than three weeks Prevents you from sleeping Is accompanied by fever over 100.4 F (38 C) Produces discolored mucus Produces blood (hemoptysis) Is associated with wheezing or shortness of breath

Causes Acute bronchitis is usually caused by viruses, typically the same viruses that cause colds and influenza. Antibiotics don't kill viruses, so this type of medication isn't useful in most cases of bronchitis. The most common cause of chronic bronchitis is smoking cigarettes. Air pollution and dust or toxic gases in the environment or workplace also can contribute to the condition. Risk Factors: Factors that increase your risk of bronchitis include: Cigarette smoke. People who smoke or who live with a smoker are at higher risk of both acute bronchitis and chronic bronchitis. Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises your immune system. Older adults, infants and young children have greater vulnerability to infection. Exposure to irritants on the job. Your risk of developing bronchitis is greater if you work around certain lung irritants, such as grains or textiles, or are exposed to chemical fumes. Complications: Although a single episode of bronchitis usually isn't cause for concern, it can lead to pneumonia in some people. Repeated bouts of bronchitis may signal: Chronic bronchitis Asthma Bronchiectasis Cystic fibrosis Tuberculosis Sinusitis

Tests and Diagnosis During the first few days of illness, it can be difficult to distinguish the signs and symptoms of bronchitis from those of a common cold. During the physical exam, your doctor will use a stethoscope to listen closely to your lungs as you breathe. In some cases, your doctor may suggest:

Chest X-ray. A chest X-ray can help determine if you have pneumonia or another condition that may explain your cough. Sputum culture. This test checks for the presence of bacteria in sputum produced when you cough. It's helpful in determining whether you have whooping cough (pertussis) or other illnesses that would be helped by antibiotics. Pulmonary function test. During a pulmonary function test, you blow into a device called a spirometer, which measures how much air your lungs can hold and how quickly you can get air out of your lungs. This test checks for signs of asthma or emphysema. Treatment and Drugs The goal of treatment for bronchitis is to relieve symptoms and ease breathing. In most cases, acute bronchitis requires only self-care treatments such as: Getting more rest Taking over-the-counter pain medications Drinking fluids Breathing in warm, moist air Medications In some circumstances, your doctor may prescribe medications, including: Antibiotics. Bronchitis usually results from a viral infection, so antibiotics aren't effective. However, your doctor may prescribe an antibiotic if he or she suspects that you have a bacterial infection. If you have a chronic lung disorder or if you smoke, your doctor may also prescribe antibiotics to reduce your risk of a serious, secondary infection. Cough medicine. It's best not to suppress a cough that brings up mucus, because coughing helps remove irritants from your lungs and air passages. Over-the-counter cough medicine may help if your cough keeps you from sleeping. Other medications. If you have asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs. Therapies If you have chronic bronchitis, you may benefit from pulmonary rehabilitation a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise.

Lifestyle and Remedies Avoid lung irritants. Don't smoke. Wear a mask when the air is polluted or if you're exposed to irritants, such as paint or household cleaners with strong fumes. Use a humidifier. Warm, moist air helps relieve coughs and loosens mucus in your airways. But be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container. Consider a face mask outside. If cold air aggravates your cough and causes shortness of breath, put on a cold-air face mask before you go outside. Prevention To reduce your risk of bronchitis, follow these tips: Avoid cigarette smoke. Cigarette smoke increases your risk of chronic bronchitis and emphysema. Get vaccinated. Many cases of acute bronchitis result from influenza, a virus. Getting a yearly flu vaccine can help protect you from getting the flu. You may also want to consider vaccination that protects against some types of pneumonia. Wash your hands. To reduce your risk of catching a viral infection, wash your hands frequently and get in the habit of using hand sanitizers. Nursing Intervention 1. Answer the patients questions and encourage him and his family to express their concerns about the illness. 2. As needed, perform chest physiotherapy, including postural drainage and chest percussion and vibration for involved lobes several times daily. 3. Make sure the patient receives adequate fluids (at least 3 liters per day) to loosen secretions. 4. Schedule respiratory therapy for the patient at least 1 hour before or after meals. 5. Provide mouth care after bronchodilator inhalation therapy. 6. Encourage daily activity and provide diversional activities as appropriate. 7. To conserve the patients energy and prevent fatigue, help him to alternate periods of rest and activity. 8. Administer medications as ordered and note the patients response to them. 9. Assess the patient for changes in baseline respiratory function. 10. Evaluate sputum quality and quantity, restlessness, increased tachypnea, and altered breath sounds. Report changes immediately.

11. Monitor the patients weight by weighing him three times weekly. Assess for edema. 12. Evaluate the patients nutritional status regularly. 13. Watch the patient for signs and symptoms of respiratory infection, such as fever, increased cough and sputum production, and purulent sputum. 14. Advise the patient to avoid crowds and people with known infections and obtain influenza and pneumococcus immunizations.