Week 4 - Discussion Chronic obstructive pulmonary disease (COPD) is a group of progressive diseases that cause breathing-related problems. Emphysema, chronic bronchitis, and sometimes asthma fall into this category. Tobacco smoke has been a key factor in the development and progression of these diseases; other factors are air pollutants, genetic factors, and respiratory infections. In 2014 COPD was the third leading cause of death in the United States. (CDC, 2016) Chronic Bronchitis Chronic bronchitis is one condition classified under COPD. Chronic bronchitis is considered when a patient has hypersecretions of mucus and chronic productive cough for at least three consecutive months, and it has occurred in more than two successive years. A cough in these patients is characterized by a raspy, hacking cough. Rhonchi can possibly clear with coughing. Prolonged expiration and wheezing are possible. Barrell chest sometimes occurs. (Dains, Baumann, Scheibel, 2016, pg. 128) It is common for a patient to present with a history of smoking, cyanosis, chronic hypoventilation, polycythemia, and Cor pulmonale. Wheezing intermittently and dyspnea in later stages. Chronic bronchitis features thickened bronchial walls, hyperplastic and hypertrophied mucous glands, and mucosal inflammation in the bronchial walls and airways. Continual bronchial inflammation causes bronchial edema, increasing the size and amount of mucus glands and goblet cells in the epithelium, smooth muscle hypertrophy with fibrosis and narrowing airways. Impaired ciliary function makes it difficult to clear the thick, tenacious mucus that is produced. (Bashers & Huether, 2017) Permanent destruction of the alveoli occurs due to the destruction of elastin. This process causes the airspaces to enlarge because the small airways and alveoli lose elasticity. The bronchioles also narrow limiting
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- chronic bronchitis