Duration: 45–60 minutes

target Audience: 5th Semester [Link]. Nursing students

Place: lecture hall

Teaching Methodology: Lecture with PowerPoint presentation, Group discussion, Q&A

Teaching Aids:

 PPT slides
 Charts
 Whiteboard/marker
Medium of instruction: English
GENERAL OBJECTIVE -

By the end of lesson plan the students will gain in depth knowledge regarding BRONCHITIS.

SPECIFIC OBJECTIVES –

By the end of the class the students will be able to:

1. Define Bronchitis
2. Enlist the etiology of bronchitis
3. Explain regarding pathophysiology of bronchitis
4. Enlist the types of bronchitis
5. Explain in detail regarding chronic bronchitis
6. Enlist the diagnostic tests for bronchitis
7. Explain regarding medical management of bronchitis
8. Explain the nursing management of bronchitis
S. TIME SPECIFIC CONTENT TEACHER STUDENT AV EVALUATION
NO. OBJECTI EVALUATIO ACTIVITY AIDS
VES N

BRONCHITIS

INTRODUCTION:
3 min
It is a condition in COPD (Chronic Obstructive Pulmonary
Disease) which effects the movement of air in and out of the
lungs. Bronchitis results from inflammation of the bronchi,
leading to increased mucous production, chronic cough and
eventual scaring of bronchial lining.

DEFINITION:
Bronchitis is an inflammation of the mucous
membrane of the bronchi (the larger and medium-sized
airways) that carry airflow from the trachea into the more Lecture Actively Green What is the
distal parts of the lung parenchyma. Bronchitis can be listening and board defination of
1 2 min Define divided into two categories: Acute and Chronic taking down and bronchitis?
Bronchitis chalk
 ETIOLOGY:

● Cigarette smoking
Green
● Exposure to pollutants
board
● Hazardous airborne substances
and
Lecture and chalk
● Susceptibility to lower respiratory tract infections discussion
3 min

PATHOPHYSIOLOGY:

Etiological causes

Green
board
and
Explain Due to Constant irritation the mucus secreting glands & Actively chalk What is the
regarding goblet cells increases in number Lecture listening and pathophysiology
2 10 min pathophysi taking down of bronchitis?
ology of
bronchitis
 Ciliary function reduces & more mucous is produced

Due to bronchial walls become thickened, the bronchial

lumen narrows

Alveoli adjacent to the bronchioles may be damaged &

fibrosed

Resulting in decreased function of the alveolar macrophages

(destroys foreign particles)

Leads to respiratory infection

TYPES:
 ❑ ACUTE

❑ CHRONIC
Green
board
and
chalk
Enlist the
types of ACUTE BRONCHITIS:
bronchitis Note down How many types
Acute bronchitis is a self-limited infection of of bronchitis?
3 5 min the lower respiratory tract causing inflammation of Lecture cum
the bronchi. Acute bronchitis is an acute illness lasting less discussion
than three weeks with coughing as the main symptom, and at
Green
least one other lower respiratory tract symptom such
board
as wheezing, sputum production, or chest pain. and
chalk
Etiology:
Explain in
detail Acute bronchitis is most often caused
regarding by viruses that infect the epithelium of the bronchi, resulting
What is chronic
chronic in inflammation and increased secretion of mucus. Acute Actively bronchitis
bronchitis bronchitis often develops during an upper respiratory Lecture and listening explain in
4 5 min discussion
infection (URI) such as the common detail ?
cold or influenza. About 90% of cases of acute bronchitis are
caused by viruses, including rhinoviruses, coronaviruses,
adenoviruses, metapneumovirus, parainfluenza
virus, respiratory syncytial virus, and influenza.
Clinical manifestations:
 ▪ Coughing as the main symptom, and at least one
other lower respiratory tract symptom such
as wheezing, sputum production or chest pain.

▪ Sore throat, shortness of breath

▪ Fatigue

▪ Runny nose

▪ Nasal congestion (coryza)

▪ Low-grade fever

▪ Malaise and the production of sputum.

CHRONIC BRONCHITIS:
Definition:
A type of chronic obstructive pulmonary disease, is
defined by a productive cough that lasts greater than three
months each year for at least two years.
Etiology:
⮚ Most cases of chronic bronchitis are caused by
smoking cigarettes or other forms of tobacco.

⮚ Additionally, chronic inhalation of air pollution or

irritating fumes or dust from hazardous exposures in
occupations such as coal mining, grain handling,
 textile manufacturing, livestock farming.
Clinical manifestations:
o Symptoms of chronic bronchitis may include
wheezing and shortness of breath, especially upon
exertion and low oxygen saturations.

o The cough is often worse soon after awakening and

the sputum produced may have a yellow or green
color and may be streaked with specks of blood.
Green
o Individuals with an obstructive pulmonary disorder board
such as bronchitis may present with a and
decreased FEV1 and FEV1/FVC ratio on pulmonary chalk
function tests. Evidence suggests that the decline in
lung function observed in chronic bronchitis may be
slowed with smoking cessation.

Taking
DIAGNOSTIC EVALUATION: down
Lecture and
● History collection regarding previous or childhood discussion
respiratory infections.

● Bronchitis may be diagnosed thorough physical

examination.

● Chest x-ray to rule out pneumonia.

● Sputum test to rule out whooping cough or other

bacterial respiratory infections.
 ● Pulmonary function test to rule out asthma or
emphysema may be used.
MEDICAL MANAGEMENT:
Prevention:
✔ Smoking cessation

✔ Minimize exposure to environmental irritants

Green
✔ Prophylactic vaccination against influenza and board
pneumonia and
chalk
✔ Antimicrobial therapy at first sign of purulent
sputum.
Treatment:
Objective is to keep bronchial tubes open and functioning,
facilitate removal of secretions.
1. Note changes in sputum ( nature, color, amount, Discussion
thickness and cough pattern) Lecture and
discussion
2. Treat recurrent bacterial infections with antibiotic
therapy.

3. Bronchodilators to remove secretions.

4. Provide chest percussion and postural drainage.

5. Give fluids orally or parenterally to liquefy

secretions
 6. Use steroid therapy when conservative measures fail.

7. Patient must stop smoking.

8. Counsel patient to avoid respiratory irritants.

9. Immune against viral agents like influenza, Green

board
pneumonia.
and
10. Treat acute upper respiratory tract infections using chalk
antimicrobial therapy.
NURSING MANAGEMENT:
Enlist
Assessment:
thediagnost
ic tests for ● Determining risk factors: assess for risk factors
bronchitis such as cigarette, cigar or other kinds of smoking or what are the
the passive inhalation of products. diagnostic tests
Actively for bronchitis?
● Obtaining health history: About current symptoms listening and
5 10 min Lecture and taking down
and previous disease manifestations like
discussion
1. Duration of respiratory difficulty

2. Dyspnea, shortness of breath, wheezing,

exercise, fatigue

3. Effect on eating and sleeping habits.

Green
● Performing physical Examination: complete
board
examination to obtain baseline data and
chalk
1. Pulse, respiratory rate and rhythm.
 2. Contraction of abdominal muscles during
inspiration.
Explain
regarding 3. Cyanosis, neck vein engorgement.
medical
managemen 4. Peripheral edema.
t of
bronchitis 5. Cough: color, amount and consistency of What is the
sputum. medical
Answering management of
Diagnosis: questions bronchitis?
6 10 min Discussion
Nursing diagnosis:
1. Ineffective airway clearance related to
bronchoconstriction, increased mucous production,
ineffective cough and broncho pulmonary infection.

2. Ineffective breathing pattern related to shortness of

breath, mucus and airway irritants.

3. Self care deficit related to fatigue secondary to

increased work of breathing and insufficient
ventilation and oxygenation.

4. Activity intolerance due to fatigue, hypoxemia and

ineffective breathing patterns.

5. Deficient knowledge regarding treatment regimen as

manifested by fear and anxiety.
Goals and Planning:
Major goal of the patient include improved gas exchange,
smoking cessation, improved breathing pattern, improved
 activity tolerance, airway clearance, improved coping
ability, improved quality of life.
Nursing Interventions:
Achieving Airway Clearance:
● Encourage high fluid intake to liquefy secretions.

● Instruct patient in directed and controlled coughing.

● Provide chest physiotherapy with postural drainage.

● Eliminate pulmonary irritants.

● Instruct patient in effective breathing techniques.

● Measure expiratory flow rate.

● Teach breath techniques.

Preventing Bronchopulmonary Infections:
● Instruct patient signs of infection eg: fever, change in Green
sputum color, character, consistency or amount. board
and
● Advice patient to avoid outdoor exposure during
chalk
Explain significant air pollution.
nursing
managemen ● Encourage immunization against influenza and
t of pneumonia.
bronchitis
Improving Activity Tolerance:
● Recommend patient with moderate life style activity.
 ● Encourage patient to avoid emotional disturbances What is the
and stressful stimuli. nursing
management of
● Recommend strategies for smoking cessation and bronchitis
7 10 min Note down
review the progress.
Lecture and
Teaching about Pulmonary Rehabilitation and Self care:
discussion
● Teach regarding breathing exercises.

● Encourage patient to do his own self care needs eg:

bathing, dressing and short walks etc

● Assess nutritional status and caloric needs and

counsel patient.

● Inform patient that smoking with or near oxygen is

extremely dangerous.

● Teach proper use of bronchodilators, inhalers.

● Teach family members regarding respiratory therapy,

physical therapy for exercise and breathing.
Evaluation:
Expected patient outcomes
● Demonstrates improved gas exchange.

● Achieves maximal airway clearance.

● Improves breathing pattern.

● Maintains maximal level of self care and physical

 functioning.

● Achieves activity tolerance and exercises and

performs activities with less shortness of breath.
SUMMARY: Bronchitis is an inflammation of the mucous
membrane of the bronchi (the larger and medium-sized
airways that carry airflow from the trachea into the more
distal parts of the lung parenchyma. Bronchitis can be
divided into two categories: Acute and Chronic. Smoking,
exposure to environmental irritants etc are the etiological
causes. Pathophysiology of bronchitis, diagnostic evaluation
like history collection, physical examination, chest X ray,
pulmonary function tests are done. Medical management and
Nursing management includes treating the underlying
causes, smoking cessation, increase intake of oral fluids and
administering antibiotics etc.

CONCLUSION: By the end of the session the students will

gain in depth knowledge regarding Bronchitis, types,
pathophysiology, Diagnostic evaluations and their
management.

BIBLIOGRAPHY:
⮚ BRUNNER & SUDDARTH’S Text book of Medical
and Surgical nursing, 11th edition, Lippincott
Williams & Wilkins publications 008, page no: 686 -
 708

⮚ JOYCE [Link] JANE HOKANSON HAWKS,

Medical – Surgical Nursing, 8th edition, Elsevier
publications, page no: 1578 – 1580.

⮚ [Link]