Bronchiectasis

Bronchiectasis is permanent widening and structural damage of the bronchi. Repeated bacterial infection and neutrophil-driven inflammation injure the airway wall, distort the bronchial lumen, and impair mucociliary clearance. The result is a self-perpetuating cycle. Thick secretions remain in the damaged bronchi instead of moving upward to be cleared. Retained mucus becomes a growth medium for bacteria; infection brings more inflammation; inflammation causes further airway damage. Airway-clearance therapy interrupts this cycle mechanically by moving secretions out of the lungs. The damage is irreversible, but symptoms, infection burden, and decline in lung function can often be reduced. A patient may have chronic daily cough and sputum at baseline. The nursing question is not simply, “Is there sputum?” but “How does today’s sputum, breathing, and oxygenation compare with this patient’s usual pattern?”