Bronchiectasis:
Bronchiectasis literally means abnormal dilation of bronchi. It is a chronic inflammatory condition which is characterised by permanent dilation of bronchi and bronchioles due to obstruction and/or infection. As a result of this there is a cavitation of bronchial and peribronchial tissue. Emphysema and pneumonia usually accompany bronchiectasis.
Etiology:
Most cases follow recurrent episodes of respiratory infections, obstruction due to foreign body, collection of thick mucus as in bronchial asthma, chronic bronchitis, and cystic fibrosis. It could be caused due to congenital disorders of bronchi such as bronchomalacia, communicating type of bronchial cyst or sequestrated lung.
Pathogenosis:
Infection damages the bronchial wall and causes segmented areas of collapse. Similarly the inhalation of foregin body, aspiration of food or mucus plug in bronchus may occlude the bronchial lumen and cause segmental areas of collapse. The bronchi are dilated due to negative pressure by the collapsed segment and may show cylinderical, fusiform or saccular dilatation. If the occlusion is relieved before the stagnant secretions are infected and the bronchial wall is damaged, the bronchiectasis the reversible.
Nursing Assessment
Child will present with persistant or recurrent cough with copious mucopurulent expectoration i.e. cough is more marked in some positions because of irritation due to infected secretions draining into fresh areas of lung. Likewise the cough is more marked when child wakes up in the morning due to change of posture. Infants and young children often have significant wheezing. There may be haemoptysis and fever, poor general health with recurrent infection, loss of appetite, irritability and poor weight gain.