Based on Mr. Miller's signs and symptoms and his X-ray and lab results, the physician diagnoses an acute exacerbation of chronic bronchitis. Normally, the brain relies on multiple feedback mechanisms to control breathing. Primarily, the brain's respiratory center responds to excess CO 2 in the blood to stimulate breathing. Ironically, by raising Mr. Miller's blood O 2 concentrations, administering O 2 at a high rate would suppress his respiratory drive. Marking the differences Although Mr. Miller's admitting diagnosis is chronic bronchitis, years of smoking increase his risk of emphysema as well.
Chronic bronchitis is persistent inflammation of the bronchial mucosa.
It occurs when hypertrophy of the bronchial mucosal glands and excessive mucus secretion congest and narrow the bronchi and bronchioles. The patient develops a persistent, productive cough. Chronic bronchitis is diagnosed when someone has a productive cough most days for at least 3 months per year for 2 consecutive years. As the disease progresses, the bronchial walls may scar, causing stenosis and airway obstruction. Because of lost resilience, the obstruction doesn't respond well to bronchodilator therapy.