What are three major causes of chronic bronchitis?
The three major causes of chronic bronchitis are cigarette smoking, long time exposure to air pollutants (such as industrial or chemical fumes), and inhalation of toxic gasses (Madell, 2016).
What are the major pathologic airway changes are associated with chronic bronchitis?
Chronic bronchitis is the condition affecting human beings that cause a continuous irritation and inflammation of the lining of the bronchial tube. Bronchial tubes are airways that carry air to and from the lungs. Exposure to cigarette smoke, air pollutants, or toxic chemicals causes a persistent cough that leads to the formation of excessive amounts of sticky mucus in the airways that result in inflammation and fibrosis. The mucus blocks the amount of air flowing into and from lungs. Over time, the blockage causes breathing difficulties (Madell, 2016).
Which acid-base imbalance is reflected by Mr. Reddington’s ABG results? Is this imbalance compensated or uncompensated? Explain your response.
What is Secondary Polycythemia? How does Mr. Reddington’s chronic bronchitis most likely contribute to the development of secondary Polycythemia?
Secondary Polycythemia refers to the increase in red blood cells in the bloodstream caused by the presence of a stimulus that enhances the production of red blood cells in the body. Increased production of red blood cells occurs because of poor oxygen supply to the blood over a long-term. The main risk factors for secondary Polycythemia include pulmonary hypertension, obstruction sleep apnea, chronic obstruction pulmonary disease (COPD), and living in high altitude areas (Nabili, 2015).
How does hypercarbia, which is characteristic of chronic bronchitis, increase Mr. Reddington’s risk for developing heart failure (HF)? If only one ventricle fails, which side of this patient’s heart is most likely to be involved and which manifestations are associated with this condition?
Hypercarbia refers to the availability of more than normal the levels of carbon dioxide in the blood. The body inhales oxygen and exhales carbon dioxide through the lungs. The condition increases the rate of breathing causing excess oxygen in the body. Chronic bronchitis is one of the major causes of Hypercarbia. A person suffering from chronic bronchitis is likely to experience Hypercarbia, which is a risk factor for developing heart failure (HF). Mr. Reddington suffers from chronic bronchitis and shows vital signs that characterize the Hypercarbia condition. Mr. Reddington is at high risks of developing heart failure because the Hypercarbia condition causes difficulties in breathing resulting from shortness of breath because of low oxygen supply to the lungs. Additionally, the 40 years of smoking experienced by Mr. Reddington may have damaged his lungs that pose difficulties in exhaling leading to accumulation of carbon dioxide. Additionally, Mr. Reddington's medical history shows the presence of hypertension caused probably by excessive smoking. The presence of these conditions is likely to inhibit the ability of the heart to pump blood around the body leading to heart failure.
The failure of one ventricle affects the left side of the patient’s heart. The condition is manifested by fluids backing up the patient’s lungs that lead to shortness of breath (Mayo Clinic Staff, 2015). Mr. Reddington already experiences shortness of breath as revealed from the case. He experienced increasing difficulties in breathing for one week.
Why has these Initial laboratory and diagnostic tests been ordered?
Complete blood count (CBC) with differential\
The complete blood count (RBC) with differential test helps differentiate bronchitis from other serious diseases affecting the lower respiratory tract characterized by coughing.
Serum electrolyte panel
The serum electrolyte panel test measures the level of electrolyte and carbon dioxide in the victim's blood. The test plays a critical role in determining the concentration of carbon dioxide in the patient's blood that assists in chronic bronchitis diagnosis. Additionally, the electrolyte test determines levels of minerals like potassium and sodium in the body. The doctor uses the test to determine the impact of medicines taken in the past on the body functioning.
Arterial blood gasses (ABGs)
The test determines the acidity levels, and levels of oxygen and carbon dioxide in the patient’s blood taken from an artery. The test helps in establishing some vital signs associated with chronic bronchitis such as acid-base balance, respiratory rate, oxygen saturation, and carbon dioxide accumulation in the body.
Sputum analysis with culture and sensitivity
The sputum analysis with culture and sensitivity test establishes the gram stain in the sputum. However, the presence of the gram stain may reveal the presence of many organisms. The doctor only considers samples that have less than 10 squamous cells and more than 25 white blood cells valid for the chronic bronchitis diagnostic test (Heath, 1998).
Chest X-ray
The doctor recommends the chest X-ray laboratory test to determine whether the patient suffers from pneumonia or any other health condition associated with a cough. People with the history of smoking, like Mr. Reddington, must undergo the chest X-ray test during chronic bronchitis diagnosis (Mayo Clinic Staff, 2014).
References
Heath, J. M. (1998, May). Chronic Bronchitis: Primary Care Management. American Family
Physician, 15(57), 2365-2372.
Madell, R. (2016). Understanding Chronic Bronchitis. Healthline. Retrieved April 08, 2016
Mayo Clinic Staff. (2015, August 18). Diseases and Conditions-Heart failure: Causes. Mayo
Clinic. Retrieved April 08, 2016 from http://www.mayoclinic.org/diseases-conditions/heart-failure/basics/causes/con-20029801
Mayo Clinic Staff. (2014, April 01). Diseases and Conditions-Bronchitis: Tests and diagnosis.
Mayo Clinic. Retrieved 8 April 2016 from http://www.mayoclinic.org/diseases-conditions/bronchitis/basics/tests-diagnosis/con-20014956
Nabili, S. N. (2015, August 14). Polycythemia. Emedicinehealth. Retrieved April 08, 2016 from
http://www.emedicinehealth.com/polycythemia_high_red_blood_cell_count/article_em.htm
