Complication of bronchiectasis is?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Medical Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Explanation

Bronchiectasis is a chronic suppurative lung disease characterized by permanent dilation of airways, leading to recurrent infections.
This chronic inflammatory state can cause both local and systemic complications.
Lung abscess is a direct, local complication from the destruction of lung tissue by infection.
Cerebral abscess is a metastatic complication caused by septic emboli traveling from the lungs to the brain.
Amyloidosis (secondary AA type) is a systemic complication resulting from the body's long-term inflammatory response.
Since Cerebral Abscess, Lung Abscess, and Amyloidosis are all recognized complications, the most comprehensive option is 'All the above'.

Option A: This option is technically correct, as a cerebral abscess is a known complication of bronchiectasis. However, it is an incomplete answer because other listed options are also correct.
Option B: This option is also correct, as a lung abscess is a common local complication. It is considered an incorrect choice here because it does not encompass all the possible complications listed.
Option C: This option is correct; secondary amyloidosis is a systemic complication of chronic inflammatory conditions like bronchiectasis. It is an incomplete choice in this context.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Bronchiectasis as background academic context rather than a clinical decision trigger.
Nurses must educate patients with bronchiectasis on airway clearance techniques to prevent the pooling of secretions that leads to complications like lung abscesses.
A critical nursing assessment includes monitoring for subtle neurological changes (e.g., persistent headache, altered mental status) in patients with chronic suppurative lung disease, as this could be the first sign of a life-threatening cerebral abscess.
For patients with long-standing bronchiectasis, nurses should monitor renal function (e.g., BUN, creatinine, urine for protein) as a baseline and for early detection of secondary amyloidosis.

How to Approach the Question

First, identify the core concept of the question, which is the 'complications' of 'bronchiectasis'.
Recall the nature of bronchiectasis: it is a chronic, infectious, and inflammatory lung disease.
Brainstorm potential complications based on this pathophysiology. Think about both local effects within the lungs (from infection and tissue damage) and systemic effects (from chronic inflammation or spread of infection).
Evaluate each option: 'Cerebral abscess' (systemic spread of infection), 'Lung abscess' (local infection/damage), and 'Amyloidosis' (systemic effect of chronic inflammation).
Recognize that all three are plausible and well-known complications.
When multiple options are individually correct, look for an umbrella option like 'All the above'. This is often the correct choice in such scenarios.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 714-716

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