Nursing management : obstructive pulmonary diseases

Imagine needing to think consciously about every breath that you take for minutes, hours or days. Many individuals with obstructive lung disease have this experience, and chronic respiratory diseases are imposing a significant, and growing, burden on resources within Australia and New Zealand. Obstructive pulmonary disease, the most common chronic lung disease, is characterised by increased resistance to airflow as a result of airway obstruction or airway narrowing. Breathlessness is a key feature of obstructive lung disease. Types of obstructive lung disease include asthma, COPD, cystic fibrosis (CF) and bronchiectasis. Asthma is a chronic inflammatory lung disease that results in variable episodes of airflow obstruction, but is usually reversible. COPD is an obstructive pulmonary disease with progressive limitation in airflow that is not fully reversible. The patient with asthma has variations in airflow over time, usually with normal lung function between exacerbations, whereas the limitation in expiratory airflow in the patient with COPD is generally more constant. The pathology of asthma and the response to therapy differ from those associated with COPD. However, the patient with a diagnosis of obstructive pulmonary disease may have features of both asthma and COPD. Patients with asthma who have less-responsive reversible airflow obstruction are difficult to distinguish from COPD patients. Cystic fibrosis , another form of obstructive pulmonary disease, is a genetic disorder that produces airway obstruction because of changes in exocrine glandular secretions, resulting in increased mucus production. Bronchiectasis is an obstructive disease characterised by dilated bronchioles. It most frequently results from untreated or poorly treated pulmonary infections that cause an increase in sputum production.