Chronic Bronchitis (Nursing)

00:00 Hi. Welcome to our video series on respiratory disorders. In this one, we're going to take a look at COPD, chronic obstructive pulmonary disease specifically at acute and chronic bronchitis. Now, the US National Institute of Health, those are the big guys in our country, talk about there being 2 main forms of COPD. One is chronic bronchitis, the other is emphysema.

00:28 So when you're talking about COPD, this is usually what we're referencing, either chronic bronchitis or emphysema. Now keep in mind sometimes patients have both. So if they have COPD they may probably have bronchitis and emphysema. But sometimes in nursing school we teach 1 diagnosis at a time. Right? But when we see real life patients they always have lots of diagnoses. But let's compare the 2. Chronic bronchitis involves a long-term cough and really thick mucus. Emphysema is, it involves some damage to the actual lungs over time. So the alveolar walls actually get blown up. So I always think of emphysema as blown up and chronic bronchitis as gunked up because they end up with this really thick tenacious mucus and an annoying cough. So let's talk about chronic bronchitis. You already know that the word chronic means over a long period of time. So a patient in order to have chronic bronchitis has a chronic productive cough they have for at least 3 months a year in 2 successive years. Man, that would stink. So you got this nasty, hacking, productive cough for at least 3 months a year for 2 years in a row. Now you also have to rule out other causes of chronic cough like bronchiectasis and so you go through a series of questions and diagnoses to make sure that this is truly chronic bronchitis. Once you have that diagnosis, we treat it a little differently.

02:03 Okay, now we're talking about airways obviously so we're going to take a look of it there.

02:07 Look at the bronchi. On the left you see normal bronchi. Right? It's clear open airway. Look at that, you've got smooth muscle wrapped around the outside, that's what those bands are.

02:18 You also have smooth muscle in the walls, an open airway, normal airway, patient can breathe well. Now when you talk about somebody who has bronchitis, look how different that airway is.

02:33 Look, the walls are thicker, the airway opening is more narrow and what they do have available is filled with gunk and mucus. So they have a significantly smaller air passageway. That's why it's so much harder for them to breathe because those bronchi, remember those are the big tubes right after the trachea, go into the lungs, the bronchi are inflamed and they're infected and so you have less area for airflow and they have that heavy thick phlegm. So mucus, phlegm, we're describing the same thing but that's what your patients with bronchitis will be dealing with. Shortness of breath plus productive cough and it's pretty thick and hard to get up. So here's what initially happens. You got this irritation and this inflamed airways then that leads to scarring. The scarring is what leads to the lining becoming thick as you see in the inflammation and mucus side of the bronchitis. So irritated, you have scarring then because of the scarring the lining becomes thickened and you have this excessive mucus produced constantly so then you end up with more permanent scarring and it just goes on and on and on and that's why patients with bronchitis are diagnosed with chronic obstructive pulmonary disease when they have experienced this. Remember, for 3 months a year, 2 years in a row.

03:56 That's when they can get their diagnosis but that means likely every year after that your patient is going to struggle.