Definition:
Bronchitis is the inflammation of the bronchi, leading to mucus production, cough, and airway irritation. It is classified as acute (short-term, usually viral) or chronic (lasting ≥3 months for at least two consecutive years, often linked to smoking or COPD)
Etiology:
- Viral infections (e.g., influenza, rhinovirus, RSV, coronavirus)
- Bacterial infections (e.g., Mycoplasma pneumoniae, Bordetella pertussis)
- Environmental irritants (e.g., smoke, pollution, dust, chemicals)
- Allergies or asthma (leading to airway inflammation)
Signs and Symptoms:
- Persistent cough (productive or dry)
- Mucus production (clear, white, yellow, or green)
- Wheezing and shortness of breath
- Chest discomfort or tightness
- Fatigue and mild fever (especially in acute cases)
- Prolonged respiratory symptoms (>3 weeks in chronic bronchitis)
Diagnosis:
- Clinical assessment (history of symptoms, exposure to irritants)
- Chest X-ray (to rule out pneumonia)
- Pulmonary function tests (PFTs) (for chronic cases)
- Sputum culture (if bacterial infection is suspected)
- Oxygen saturation (to assess respiratory function)
Treatment:
Acute Bronchitis:
- Supportive care: Hydration, humidified air, rest
- Symptom relief: NSAIDs, acetaminophen, antitussives (if necessary)
- Bronchodilators (e.g., albuterol): If wheezing is present
- Avoidance of irritants (e.g., smoking, pollution)
- Antibiotics only if bacterial infection is confirmed
Chronic Bronchitis (COPD-related):
- Smoking cessation (essential for symptom control)
- Bronchodilators: Beta-agonists (e.g., albuterol) or anticholinergics (e.g., ipratropium)
- Corticosteroids: For severe inflammation
- Pulmonary rehabilitation: Breathing exercises, oxygen therapy (if needed)
Nursing Considerations (NCLEX Focus):
- Encourage flu and pneumonia vaccinations
- Promote smoking cessation education
- Teach proper cough hygiene to prevent infections
- Monitor for worsening respiratory distress
- Educate about avoiding lung irritants
- Recognize signs of COPD progression in chronic cases
References:
- American Lung Association. (2022). Bronchitis: Causes, symptoms, and treatment. https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchitis
- Bernstein, J. A., & Chakraborty, R. (2020). Management of acute and chronic bronchitis. New England Journal of Medicine, 382(2), 180-189. https://doi.org/10.1056/NEJMra1911622
- Centers for Disease Control and Prevention (CDC). (2022). Bronchitis: Symptoms and prevention. https://www.cdc.gov/bronchitis
- Chang, A. B., Oppenheimer, J. J., & Weinberger, M. M. (2021). Diagnosis and treatment of bronchitis: Clinical practice guidelines. Chest, 160(4), 1268-1284. https://doi.org/10.1016/j.chest.2021.06.002
- Ghosh, B., & Shah, R. (2020). Chronic bronchitis: Pathophysiology and management. International Journal of Respiratory Medicine, 45(3), 243-256. https://doi.org/10.1007/s11515-020-1234-x
- Global Initiative for Chronic Obstructive Lung Disease (GOLD). (2023). Chronic bronchitis and COPD management guidelines. https://goldcopd.org
- Mayo Clinic. (2023). Bronchitis: Overview and treatment. https://www.mayoclinic.org/diseases-conditions/bronchitis
- Merck Manual. (2021). Bronchitis: Symptoms, causes, and treatment. https://www.merckmanuals.com/home/lung-and-airway-disorders/bronchitis
- National Heart, Lung, and Blood Institute (NHLBI). (2022). Bronchitis: Understanding respiratory diseases. https://www.nhlbi.nih.gov/health/bronchitis
- Sethi, S., & Murphy, T. F. (2020). Bacterial infections and exacerbations in chronic bronchitis. Lancet Respiratory Medicine, 8(2), 235-247. https://doi.org/10.1016/S2213-2600(20)30015-4