Chronic bronchitis and chronic obstructive emphysema, if there is chronic airway obstruction and ventilation, are called chronic obstructive pulmonary disease (chronic bronchitis refers to chronic nonspecific inflammation of trachea, bronchus and its surrounding tissues, and chronic obstructive emphysema refers to the expansion of the air cavity at the distal end of terminal bronchus and the destruction of alveolar wall). The clinical features are chronic repeated cough, expectoration or wheezing, and the disease often progresses slowly, which may be combined with chronic obstructive emphysema and chronic pulmonary heart disease.
The cause of chronic bronchitis is very complicated. Due to autonomic nervous dysfunction, airway responsiveness increases, local defense function decreases, and external stimuli are weak, such as smoke and dust, allergen inhalation, and sudden drop in temperature. Tracheal spasm and increased secretion lead to cough, expectoration or asthma. Long-term repeated infection and smoking are the main reasons for the occurrence and aggravation of chronic bronchitis.
Psychological guidance
Make patients understand the characteristics of chronic obstructive pulmonary disease with long course and recurrent attacks, make full preparations, listen to the guidance of medical staff and actively participate in treatment and rehabilitation nursing activities, so as to improve the body's resistance, improve respiratory function, delay the progress of the disease and improve the quality of life.
Dietary guidance
Choose a diet with high protein and vitamins, which is light, digestible and nutritious. Such as lean meat, tofu, eggs, fish, fresh vegetables and fruits.
Medication guidance
According to the results of sputum culture, antibiotics were selected. The application of antibiotics can use narrow spectrum alone, and try not to use broad spectrum antibiotics to avoid double infection or drug-resistant strains.
2. The use of powerful antitussive drugs, such as codeine phosphate, should be avoided, so as not to inhibit the central nervous system and aggravate respiratory obstruction and inflammation. Those who are old, weak, cough or expectoration should give priority to expectorant drugs.
Discharge guidance
1. Keep the indoor air fresh, open the window regularly and ventilate to avoid smoke stimulation. It is recommended that smokers quit smoking and keep warm in cold season or sudden climate change to prevent colds and respiratory infections.
2. Try to cough up the sputum for a long time, especially in the early morning. Those who are tired and sticky should take expectorant drugs or atomize people to dilute the sputum. The elderly and infirm can help turn over or pat their backs to help cough up phlegm.
3. Untreated patients with chronic bronchitis should insist on medication to eliminate symptoms.
4. Pay attention to the cleanliness of the mouth and skin.
5. Exercise respiratory muscle function, do abdominal breathing, contract lips and exhale slowly, strengthen the movement of respiratory muscles, increase the activity of diaphragm and improve ventilation. The method is: take supine or semi-supine position, bend your hands, and lean forward slightly when standing, so that the abdominal guanidine can relax freely:: inhale through your nose, exhale through your mouth and lips, breathe slowly and evenly, and don't exhale forcibly. Inhale to the abdominal muscles, and the abdomen bulges. When exhaling, the abdominal muscles contract and the abdomen sinks. At the beginning of training, patients can put one hand on the abdomen and the other hand on the chest to feel the ups and downs of the chest and abdomen. When breathing, the chest should be kept at a minimum range of motion. The abdomen can be properly pressurized by hand to increase the activity of diaphragm when breathing. After practicing several times, you can have a rest and continue training after exchanging positions with your hands. Training twice a day, each time 10 ~ 15 minutes. You can gradually increase the number and time of training in the future, and you can practice at any position at will. Pay attention to the muscles of the whole body during training, especially the auxiliary breathing muscles to relax and breathe calmly.
6. Encourage oxygen therapy at home. Giving oxygen 12- 15 hours a day can prolong life.
7. Maintain emotional stability and relieve mental anxiety and depression.
Effect evaluation
1. Patients have disease knowledge;
2. Behavior changes after receiving education.