Altered Pulmonary Conditions and Specific Nursing Management :

 Altered Pulmonary Conditions and Specific Nursing Management :

This document provides detailed descriptions of altered pulmonary conditions, including their etiology, clinical manifestations, diagnosis, prognosis, related pathophysiology, treatment modalities, and specific nursing management.

1. Bronchitis

  • Etiology: Viral or bacterial infections, smoking, air pollutants.
  • Clinical Manifestations: Persistent cough, sputum production, wheezing, dyspnea.
  • Diagnosis: Clinical history, sputum culture, chest X-ray.
  • Prognosis: Good with early treatment; chronic cases may lead to COPD.
  • Pathophysiology: Inflammation of the bronchial mucosa increases mucus production and airway obstruction.
  • Treatment Modalities: Bronchodilators, antitussives, antibiotics if bacterial.
  • Nursing Management:
    • Encourage fluid intake.
    • Educate on avoiding irritants.
    • Monitor respiratory status.

2. Bronchial Asthma

  • Etiology: Allergens, exercise, infections, genetic predisposition.
  • Clinical Manifestations: Wheezing, dyspnea, chest tightness, cough.
  • Diagnosis: Pulmonary function tests (PFTs), peak flow measurement.
  • Prognosis: Variable; controlled with adherence to treatment.
  • Pathophysiology: Airway hyperresponsiveness leads to bronchospasm, inflammation, and mucus secretion.
  • Treatment Modalities: Inhaled corticosteroids, bronchodilators, leukotriene modifiers.
  • Nursing Management:
    • Teach inhaler use.
    • Monitor for triggers and advise avoidance.
    • Provide emotional support.

3. Bronchiectasis

  • Etiology: Recurrent infections, cystic fibrosis, immune deficiencies.
  • Clinical Manifestations: Chronic cough, purulent sputum, hemoptysis.
  • Diagnosis: High-resolution CT scan, sputum culture.
  • Prognosis: Progressive if untreated.
  • Pathophysiology: Irreversible dilation of bronchi due to destruction of the bronchial wall.
  • Treatment Modalities: Antibiotics, chest physiotherapy, bronchodilators.
  • Nursing Management:
    • Encourage postural drainage.
    • Teach effective coughing techniques.
    • Monitor for signs of infection.

4. Pneumonias

  • Etiology: Bacterial, viral, fungal, or aspiration.
  • Clinical Manifestations: Fever, chills, cough, pleuritic chest pain, dyspnea.
  • Diagnosis: Chest X-ray, sputum analysis, blood cultures.
  • Prognosis: Generally good with early treatment; complications include sepsis and ARDS.
  • Pathophysiology: Infection leads to alveolar inflammation and fluid accumulation.
  • Treatment Modalities: Antibiotics, antipyretics, oxygen therapy.
  • Nursing Management:
    • Administer prescribed antibiotics.
    • Promote hydration.
    • Encourage deep breathing exercises.

5. Lung Abscess, Lung Tumor

  • Etiology: Aspiration (abscess), smoking, occupational exposures (tumor).
  • Clinical Manifestations: Productive cough, weight loss, hemoptysis (tumor-specific symptoms).
  • Diagnosis: CT scan, bronchoscopy, biopsy.
  • Prognosis: Varies; poor in metastatic lung tumors.
  • Pathophysiology: Localized pus formation (abscess) or malignant cell proliferation (tumor).
  • Treatment Modalities: Antibiotics, surgical drainage (abscess), chemotherapy, radiotherapy (tumor).
  • Nursing Management:
    • Monitor respiratory status.
    • Provide emotional support for cancer patients.
    • Educate on smoking cessation.

6. Pulmonary Tuberculosis (TB)

  • Etiology: Mycobacterium tuberculosis.
  • Clinical Manifestations: Chronic cough, night sweats, weight loss, hemoptysis.
  • Diagnosis: Sputum AFB, chest X-ray, Mantoux test.
  • Prognosis: Curable with adherence to treatment.
  • Pathophysiology: Granulomas form in the lungs due to immune response.
  • Treatment Modalities: Long-term antibiotics (e.g., rifampin, isoniazid).
  • Nursing Management:
    • Ensure adherence to drug regimen.
    • Educate on infection control.
    • Monitor for drug side effects.


7. Pleuritis, Pleural Effusion

  • Etiology: Infections, malignancy, autoimmune conditions.
  • Clinical Manifestations: Sharp chest pain, dyspnea, diminished breath sounds.
  • Diagnosis: Chest X-ray, ultrasound, thoracentesis.
  • Prognosis: Depends on underlying cause.
  • Pathophysiology: Inflammation (pleuritis) or fluid accumulation (effusion) in the pleural space impairs lung expansion.
  • Treatment Modalities: Analgesics, antibiotics, pleurodesis.
  • Nursing Management:
    • Assist with thoracentesis.
    • Monitor for respiratory distress.
    • Provide pain relief.

8. Pneumo, Hemothorax, Pyothorax

  • Etiology: Trauma, infections, malignancy.
  • Clinical Manifestations: Chest pain, dyspnea, decreased breath sounds.
  • Diagnosis: Chest X-ray, CT scan.
  • Prognosis: Depends on rapidity of intervention.
  • Pathophysiology: Air (pneumothorax), blood (hemothorax), or pus (pyothorax) in pleural space.
  • Treatment Modalities: Chest tube insertion, antibiotics (pyothorax).
  • Nursing Management:
    • Monitor chest tube function.
    • Observe for signs of infection.
    • Provide patient education on breathing exercises.

9. Interstitial Lung Disease (ILD)

  • Etiology: Autoimmune disorders, occupational exposure.
  • Clinical Manifestations: Progressive dyspnea, dry cough.
  • Diagnosis: High-resolution CT, lung biopsy.
  • Prognosis: Chronic and progressive.
  • Pathophysiology: Fibrosis thickens alveolar walls, impairing gas exchange.
  • Treatment Modalities: Corticosteroids, antifibrotic agents, oxygen therapy.
  • Nursing Management:
    • Educate on energy conservation.
    • Provide oxygen therapy.
    • Monitor respiratory status.

10. Cystic Fibrosis

  • Etiology: Genetic mutation affecting chloride channels.
  • Clinical Manifestations: Chronic cough, thick mucus, malabsorption.
  • Diagnosis: Sweat chloride test, genetic testing.
  • Prognosis: Variable; improved with early interventions.
  • Pathophysiology: Thick secretions obstruct airways and pancreatic ducts.
  • Treatment Modalities: Airway clearance, enzyme replacement, antibiotics.
  • Nursing Management:
    • Teach airway clearance techniques.
    • Monitor for respiratory infections.
    • Provide nutritional support.

11. Chronic Obstructive Pulmonary Disease (COPD)

  • Etiology: Smoking, pollution, recurrent infections.
  • Clinical Manifestations: Chronic cough, dyspnea, barrel chest.
  • Diagnosis: Spirometry, chest X-ray.
  • Prognosis: Progressive with acute exacerbations.
  • Pathophysiology: Chronic inflammation narrows airways and destroys alveoli.
  • Treatment Modalities: Bronchodilators, corticosteroids, oxygen therapy.
  • Nursing Management:
    • Educate on smoking cessation.
    • Encourage pulmonary rehabilitation.
    • Monitor oxygen saturation.

12. Pulmonary Embolism (PE)

  • Etiology: DVT, immobility, surgery.
  • Clinical Manifestations: Sudden dyspnea, chest pain, hemoptysis.
  • Diagnosis: D-dimer, CT pulmonary angiography.
  • Prognosis: Life-threatening if untreated.
  • Pathophysiology: Embolus obstructs pulmonary artery, impairing perfusion.
  • Treatment Modalities: Anticoagulants, thrombolytics.
  • Nursing Management:
    • Monitor for signs of PE.
    • Administer anticoagulants.
    • Educate on mobility and DVT prevention.

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