IX.

Ecologic Model

A. Hypothesis
Permanent dilatation of the bronchi and bronchioles caused by destruction of the muscle
and elastic supporting tissues can lead to Bronchiectasis secondary to Pulmonary Tuberculosis.

B. Predisposing Factors
a. Host
• Behaviour – chronic smoker consumes 1 pack of cigarettes per day. Started
smoking by age 20.

b. Agent
• Mycobacterium Tuberculosis infection present in the patient,.

c. Environment
• Socio-economic – the patient belongs to a low income earning family which
makes it difficult to religiously attend to his medications and treatment needs.

C. Ecologic Model
The lever model is used to show the relationship between the host, agent and the
environment and to determine if there is an imbalance between the three (3) predisposing factors
that may lead to an occurrence of disease.

The diagram below shows the possible imbalance of the ecologic model caused by lifestyle of
the client, PTB infection in the patient leading to destruction of the muscle and elastic supporting
tissues leading to Bronchiectasis.
 PTB infection in Patient with
the patient leading history of chronic
to destruction of smoking.
the muscle and
elastic supporting
tissues.

ENV

D. Analysis
Bronchiectasis is not a primary disease but occurs secondary to persistent infection or
obstruction. In the past, bronchiectasis often followed a necrotizing bacterial pneumonia that
frequently complicated measles, pertussis, or influenza. Tuberculosis was also commonly
associated with bronchiectasis. Thus, the advent of antibiotics that more effectively treat
respiratory infections such as tuberculosis and immunizations against pertussis and measles,
there have been marked decrease in the prevalence of bronchiectasis. (Essentials of
Pathophysiology. by Carol Mattson Porth. p. 505)

E Conclusion and Recommendations

I therefore conclude that having PTB can greatly lead to Bronchiectasis because PTB
infection can eventually cause damage to the bronchial walls, leading to weakening and
dilatation.
Recommendations consist of early recognition and treatment of infection along with
regular postural drainage and chest physical therapy. Religious taking of PTB drugs is also
recommended to prevent further infection.