BRONCHIECTASIS (ACQUIRED)

ICD-9: 490.0

Description

Bronchiectasis is the widening and destruction of the large airways or bronchi, usually in the lower lung portions.

Etiology

The common cause is recurrent inflammation or infection of the airways. Cystic fibrosis is a cause in nearly half of all cases. Risk factors include recurrent lung infections, tuberculosis, and obstruction of the airways by a foreign body or tumor.

Signs and Symptoms

Symptoms may develop gradually and can include chronic cough with large amounts of foul-smelling sputum, bluish skin color, hemoptysis, fatigue, paleness, shortness of breath, weight loss, and wheezing.

Diagnostic Procedures

Auscultation reveals small clicking, wheezing, bubbling, rattling sounds, usually in the lower lung lobes. Chest x-ray, CT scan, complete blood count (CBC), and tuberculin skin test are often ordered.

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Treatment

Treatment aims at controlling infections and bronchial secretions and relieving airway obstruction. Antibiotics, bronchodilators, and expectorants may be prescribed. Regular, daily drainage to remove bronchial secretions is important.

Complementary Therapy

A respiratory therapist can show clients coughing exercises that help reduce bronchial secretions.

CLIENT COMMUNICATION

If chest pain or shortness of breath gets worse or if bloody phlegm is coughed up remind clients to return to their primary care provider.

Prognosis

The prognosis is good with treatment, and most individuals live a normal life without major disability.

Prevention

Treat lung infections promptly; get the influenza vaccine; and avoid upper respiratory infections, smoking, and pollution.

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Chronic obstructive pulmonary disease: pulmonary emphysema and chronic bronchitis ICD-9: 491.21 Description Chronic obstructive pulmonary disease (COPD) is a functional diagnosis given to any pathological process that decreases the ability of the lungs and bronchi to perform their function of ventilation. It is an umbrella term that includes pulmonary emphysema and chronic bronchitis. COPD affects 12 million Americans, and it is estimated that 12 million more are undiagnosed. It is a common cause of death and disability in the United States. Pulmonary emphysema (ICD-9:492) is the permanent enlargement of the air spaces beyond the terminal bronchioles resulting from destruction of alveolar walls. As a consequence of this destruction, the lungs slowly lose their normal elasticity. Air reaches the alveoli in the lungs during inhalation but may not be able to escape during exhalation. Evidence suggests that some forms of the emphysema may be hereditary. In rare instances, emphysema is associated with a deficiency of a1-antitrypsin, a protein that plays a role in ...
RESPIRATORY SYSTEM ANATOMY AND PHYSIOLOGY REVIEW Respiration is essential for life. The body can survive a fair length of time without food, a few days without water, but only minutes without air. Refer to Figure for a review of the structure of the respiratory system. FIGURE. The respiratory system. There are two levels involved in the respiratory process: external and internal respiration. External respiration is the exchange of two gases within the lungs. Oxygen that is present in inhaled air is exchanged for carbon dioxide that diffuses from the blood, across cell walls, into the air spaces of the lungs. The carbon dioxide is then exhaled from the lungs. Internal respiration is the exchange of oxygen and carbon dioxide at the cellular level within the organs of the body. Carbon dioxide is a waste product that results when oxygen and nutrients are metabolized within body cells. The respiratory system is divided between the upper respiratory tract and the lower respiratory tract. The upper tract is composed of the organs l...
Understanding ARDS Acute respiratory distress syndrome (ARDS) is sudden, life-threatening lung failure. ARDS occurs when the alveoli become inflamed and filled with liquid, causing their collapse. Gas exchange ceases, and the body is starved for oxygen. ARDS is a syndrome rather than a disease. It most often occurs within 24 to 48 hours of injury or illness, and the intensity and duration varies from one person to another. The mortality rate ranges from 35% to 50%, in most cases as a result of underlying disease or mechanical ventilation complications.
Respiratory acidosis (Hypercapnia) ICD-9: 276.4 Description Respiratory acidosis is excessive acidity of body fluids attributable to inadequate removal of carbon dioxide (CO2) by the lungs. Whenever CO2 cannot be adequately ventilated, the CO2 dissolved in the blood rapidly increases. As the level of CO2—called the partial pressure of carbon dioxide (PaCO2)—rises, so does the amount of CO2 that combines with water to form carbonic acid. Consequently, the acidity or alkalinity (pH) of the blood decreases. The condition may be acute or chronic. Etiology Acute respiratory acidosis occurs whenever there is a sudden impairment of ventilation resulting from airway obstruction. This may be due to such causes as a foreign object blocking the airway or to the effects of certain drugs, neuromuscular diseases, or cardiac arrest. Chronic respiratory acidosis is caused by pulmonary diseases that change the characteristics of lung tissue, impairing the ability to release CO2. Examples of such diseases include emphysema, bro...
Berylliosis ICD-9: 503 Description Berylliosis is beryllium poisoning, usually of the lungs. The skin and other bodily organs also may be affected. The acute form of the disease is characterized by the onset of pneumonia-like symptoms and other respiratory tract disorders. The more common, chronic form is characterized by granuloma formation and diffuse interstitial pneumonitis. Etiology Those at risk of contracting berylliosis include workers in primary production, metal machining, and reclaiming scrap alloys. Other high-exposure occupations are in the nuclear power, aerospace, and electronics industries. The metal may be either inhaled or directly absorbed through the skin in the form of dusts, salts, or fumes. As with asbestosis, berylliosis can affect family members who are exposed to dust in the worker’s clothing. Signs and Symptoms After exposure, dry cough and nasal mucosal swelling with ulceration occur. As the condition worsens, substernal pain, tachycardia, dyspnea, weigh...