Nursing Discussion

1) Post a response to one peer in your discussion group to further the discussion.

Peer 1

The Pathophysiologic Process of Bronchiolitis and Bronchiectasis

Bronchiolitis is a respiratory death-threatening disorder that starts with acute viral infection of the epithelial cells lining. The most common infectious agent related to this disorder includes respiratory syncytial virus, adenovirus, influenza virus, metapneumovirus, and parainfluenza virus. Bronchiolitis pathophysiology starts with an epithelial cell infection in the opening of the airways within the lungs (McCance & Huether, 2018). The infection later results in edema, eventual necrosis, increased mucus production, and rejuvenation of cells. 

There is an obstruction of the airways in the lungs due to edema, excessive mucus secretion, and inflammation, leading to hyperinflation, atelectasis, ventilation-perfusion mismatch, and bronchioles airways contraction. Infant and young children are the most affected due to their small airways, inadequate collateral ventilation, and high close volume. Bronchiolitis is spread through direct contact with mucus secretion. Symptoms related to this disorder include hypoxia, rhinitis, cough, variable wheezing, and tachypnea. Pathophysiology of bronchiectasis

Bronchiectasis disorder pathophysiology disorder can be described in distinct phases of infection and inflammation, destroying bronchioles. In the initial phase of bronchiectasis development, the mucociliary response is triggered by the constriction of airways. The pathogens activate the release of toxins and inflammatory response within the bronchiole’s airways—the inflammation results in the release of lymphocytes, macrophages, and neutrophils within the epithelium lining. Neutrophils distract the cilial epithelium’s normal operation, resulting in cilial beat frequency and excessive mucus production. They are also believed to facilitate bacterial growth in the epithelium lining in the lungs (Menéndez & Sibila, 2017). In response to this, a cycle of an intense chronic inflammatory response is initiated, which trigger the further release of inflammatory mediators that destroy bronchial elastin and other lung supporting structure, resulting in permanent bronchi dilatation. The airways are thickened with normal mucosa layer and muscular layer substituted by edema, fibrosis, or ulceration.

Comparison Between Pathophysiologic Process ofBronchiolitis and Bronchiectasis

Although they are different disorders, there are similarities between bronchiolitis and bronchiectasis pathophysiological processes. Both conditions cause inflammation in the epithelium lining within the lungs. Moreover, both infections result in almost similar symptoms, including coughing, sneezing, edema, and mucus overproduction. Both conditions affect the small airways within the lung, restricting airflow in and out of the lungs.  

The difference between the two is that bronchiectasis involves inflammation of the airways that lead to the windpipe. In contrast, bronchiolitis involves the inflammation of the airways that branch off the bronchioles (McCance & Huether, 2018). Moreover, bronchiolitis affects infants and young children, while bronchiectasis infection affects all people regardless of age. Both conditions show similar symptoms but the areas affected are different, and the symptoms vary, ranging from mild to severe. Bronchiectasis does not permanently change in structure and shape of bronchi. In comparison, bronchiectasis infection results in a permanent change in the shape and structure of the bronchi.

References

McCance, K., L., & Huether, S., E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby Inc.

Menéndez, R., & Sibila, O. (2017). Pathophysiology, immunology, and histopathology of bronchiectasis. Bronchiectasis, 51-64. https://doi.org/10.1007/978-3-319-61452

2) Post a response to one peer in your discussion group that provides a clinical example of bronchiolitis and bronchiectasis.


Peer 2

Inflammation of the bronchioles is what is referred to as Bronchiolitis. Typically, bronchiolitis occurs in infants and is most commonly causation of a virus called RSV (respiratory syncytial virus). Bronchiolitis can also be caused by other viruses such as a dental virus influenza and Parainfluenza virus (Kavaliunaite & Aurora, 2019).. 

Bronchiectasis

The abnormal dilation of the bronchus that can occur from birth or as a secondary occurrence is referred to as Bronchiectasis (Butler & Keane, 2017). This abnormal dilation can lead to inflammation and a destructed airway (McCance et al., 2019).  

Comparison & Contrasts

The respiratory system is extremely complex for every symptom that involves cough and dyspnea there is a multitude of respiratory compromises that are linked to causation. Among the very many respiratory causations that could indicate cough and dyspnea pulmonologists and primary care physicians have to ensure other factors are reviewed in an effort to gather the right diagnosis (McCance et al., 2019). There are many differences among Bronchiectasis takes place in the bronchus system whereas bronchiolitis takes place in the actual bronchioles further down. Outside of the anatomic positional differences their causations are also different as well. Bronchiectasis not only leads to inflammation and destruction of the airway but it can be considered a chronic obstructive pulmonary disease (Butler & Keane, 2017). Patients with Bronchiectasis can be asymptomatic or may have intermittent symptoms (Butler & Keane, 2017). Whereas bronchiolitis is directly linked with a viral entity this symptom of respiratory distress is also associated with viral indications such as tachycardia nasal flaring and it’s also associated with the upper respiratory symptom of distress (Kavaliunaite, E., & Aurora, P. 2019). Treatment for bronchiolitis involves supportive treatment that because it in is intertwined with a viral infection whereas bronchial stasis although chronic would involve antibiotic treatment as the inflammatory airway of Bronchiectasis causes stasis of purulent or foul-smelling sputum it can also indicate hemoptysis and in induction of infection (Butler & Keane, 2017). Also, bronchiolitis typically affects children and infants of the younger years. All in all, bronchiolitis is the inflammatory process that occurs to the smaller Airways that branch off of the actual bronchus and Bronchiectasis is the damage of the airway the bronchus and it creates scarred and dilated bronchus airways. 

References:

Butler, M. W., & Keane, M. P. (2017). Bronchitis, Bronchiectasis. Infectious Diseases. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7150028/.

Kavaliunaite, E., & Aurora, P. (2019). Diagnosing and managing bronchiolitis obliterans in children. Expert Review of Respiratory Medicine, 13(5), 481–488. https://doi.org/10.1080/17476348.2019.1586537

McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2019). Pathophysiology: the biologic basis for disease in adults and children. Elsevier.

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