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Atelectasis
Dr.Arjun Patel
Introduction
Atelectasis is defined as the collapse or closure of the
lung resulting in reduced or absent gas exchange. It
may affect part or all of one lung
Atelectasis is the collapse of alveoli or lung tissue.
It develops when the alveoli becomes airless from
absorption of their air without replacement of the air
with breathing.
Contd…
Atelectasis may be acute or chronic
The most commonly described
atelectasis is acute atelectasis, which
occurs frequently in the postoperative
setting or
immobilized
in people who are
and have a shallow,
monotonous breathing pattern.
Etiology
Obstruction of an airway
Diminished distention of alveoli
Contd
Airway foreign body
Extrinsic compression on an airway (eg,
compression due to an enlarged or aberrant vessel)
Enlarged lymph nodes that compress the airway
Masses in the chest that compress the airway or
alveoli
Cardiomegaly or enlarged pulmonary vessels that
compress adjacent airways
Etiology of atelectasis
Altered breathing patterns
Retained secretions
Pain, alterations in small airway function
Anesthesia or sedation
Increased abdominal pressure
Reduced lung volumes due to musculoskeletal
(Severe scoliosis) or neurologic disorders
Pain from upper abdominal surgery
Contd…
Restrictive defects, and specific surgical
procedures (eg, upper abdominal, thoracic, or
open heart surgery).
Persistent low lung volumes
Secretions or a mass obstructing or impeding
airflow and compression of lung tissue
Bronchospasm, airway secretions and
airway inflammation in patients with
asthma
Abnormal airway secretions in cystic fibrosis
Contd….
Abnormal airway clearance, such as with ciliary
dyskinesia syndrome
Airway foreign body
Excessive pressure on the lung tissue (pleural
effusion, pneumothorax, hemothorax)
Tumor growth within the thorax, or an elevated
diaphragm
Pathophysiology
Reduced alveolar ventilation or any type of blockage
Impedes the passage of air
The trapped alveolar air becomes absorbed into the
bloodstream, but outside air cannot replace the absorbed
air because of the blockage
Isolated portion of the lung becomes airless and the
alveoli collapse.
Excessive pressure on the lung tissue
Restricts normal lung expansion on inspiration
Becomes airless for prolong period
Alveolar colapse
Clinical Manifestations
Cough, sputum production, and low-grade fever.
Marked respiratory distress
Dyspnea, tachycardia,
Tachypnea, pleural pain, and central cyanosis
Difficulty breathing in the supine position
Anxious
Assessment and Diagnostic Findings
Chest x-ray : patchy infiltrates or consolidated
areas.
Pulse oximetry: (SpO2) (less than 90%) or a
(PaO2).
Physical examination: Decreased breath sounds
and crackles are heard over the affected area.
Prevention
Frequent turning, early mobilization,
Strategies to expand the lungs and to manage
secretions.
Deep-breathing maneuvers (at least every 2 hours)
The use of incentive spirometry or voluntary deep
breathing
Directed cough, suctioning, aerosol nebulizer
treatments followed by chest physical therapy
Postural Drainage and chest percussion, or
bronchoscopy
Contd..
Change patient’s position frequently, especially
from supine to upright position, to promote
ventilation and prevent secretions from
accumulating.
Encourage early mobilization from bed to chair
followed by early ambulation.
Encourage appropriate deep breathing and
coughing to mobilize secretions and prevent
them from accumulating.
Contd…
Administer prescribed Opioids and sedatives
judiciously to prevent respiratory depression.
Perform postural drainage and chest percussion,
if indicated.
Institute suctioning to remove tracheobronchial
secretions, if indicated.
Management
The goal in treating the patient with atelectasis is to
improve ventilation and remove secretions
In patients who do not respond to first-line measures or
who cannot perform deep-breathing exercises, other
treatments such as positive expiratory pressure (PEP
therapy )
If the cause of atelectasis is bronchial obstruction
from secretions, the secretions must be removed by
coughing or suctioning to permit air to re-enter that
portion of the lung
Chest physical therapy (chest percussion and
postural drainage)
Nebulizer treatments with a bronchodilator
Medication or sodium bicarbonate may be used
to assist the patient in the expectoration of
secretions.
If respiratory care measures fail to remove the
obstruction, a bronchoscopy is performed.
Endotracheal intubation and mechanical
ventilation may be necessary for respiratory failure
Contd…
Thoracentesis, removal of the fluid by needle
aspiration, or insertion of a chest tube if cause is
compression
Bronchoscopy
Nursing diagnosis
Ineffective breathing pattern related to
collapse of lung tissue
Activity intolerance
Thank You

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Atelectasis 160424141702-converted

  • 2. Introduction Atelectasis is defined as the collapse or closure of the lung resulting in reduced or absent gas exchange. It may affect part or all of one lung Atelectasis is the collapse of alveoli or lung tissue. It develops when the alveoli becomes airless from absorption of their air without replacement of the air with breathing.
  • 3.
  • 4. Contd… Atelectasis may be acute or chronic The most commonly described atelectasis is acute atelectasis, which occurs frequently in the postoperative setting or immobilized in people who are and have a shallow, monotonous breathing pattern.
  • 5. Etiology Obstruction of an airway Diminished distention of alveoli
  • 6. Contd Airway foreign body Extrinsic compression on an airway (eg, compression due to an enlarged or aberrant vessel) Enlarged lymph nodes that compress the airway Masses in the chest that compress the airway or alveoli Cardiomegaly or enlarged pulmonary vessels that compress adjacent airways
  • 7. Etiology of atelectasis Altered breathing patterns Retained secretions Pain, alterations in small airway function Anesthesia or sedation Increased abdominal pressure Reduced lung volumes due to musculoskeletal (Severe scoliosis) or neurologic disorders Pain from upper abdominal surgery
  • 8. Contd… Restrictive defects, and specific surgical procedures (eg, upper abdominal, thoracic, or open heart surgery). Persistent low lung volumes Secretions or a mass obstructing or impeding airflow and compression of lung tissue Bronchospasm, airway secretions and airway inflammation in patients with asthma Abnormal airway secretions in cystic fibrosis
  • 9. Contd…. Abnormal airway clearance, such as with ciliary dyskinesia syndrome Airway foreign body Excessive pressure on the lung tissue (pleural effusion, pneumothorax, hemothorax) Tumor growth within the thorax, or an elevated diaphragm
  • 10. Pathophysiology Reduced alveolar ventilation or any type of blockage Impedes the passage of air The trapped alveolar air becomes absorbed into the bloodstream, but outside air cannot replace the absorbed air because of the blockage Isolated portion of the lung becomes airless and the alveoli collapse.
  • 11. Excessive pressure on the lung tissue Restricts normal lung expansion on inspiration Becomes airless for prolong period Alveolar colapse
  • 12. Clinical Manifestations Cough, sputum production, and low-grade fever. Marked respiratory distress Dyspnea, tachycardia, Tachypnea, pleural pain, and central cyanosis Difficulty breathing in the supine position Anxious
  • 13. Assessment and Diagnostic Findings Chest x-ray : patchy infiltrates or consolidated areas. Pulse oximetry: (SpO2) (less than 90%) or a (PaO2). Physical examination: Decreased breath sounds and crackles are heard over the affected area.
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  • 15. Prevention Frequent turning, early mobilization, Strategies to expand the lungs and to manage secretions. Deep-breathing maneuvers (at least every 2 hours) The use of incentive spirometry or voluntary deep breathing Directed cough, suctioning, aerosol nebulizer treatments followed by chest physical therapy Postural Drainage and chest percussion, or bronchoscopy
  • 16. Contd.. Change patient’s position frequently, especially from supine to upright position, to promote ventilation and prevent secretions from accumulating. Encourage early mobilization from bed to chair followed by early ambulation. Encourage appropriate deep breathing and coughing to mobilize secretions and prevent them from accumulating.
  • 17. Contd… Administer prescribed Opioids and sedatives judiciously to prevent respiratory depression. Perform postural drainage and chest percussion, if indicated. Institute suctioning to remove tracheobronchial secretions, if indicated.
  • 18. Management The goal in treating the patient with atelectasis is to improve ventilation and remove secretions In patients who do not respond to first-line measures or who cannot perform deep-breathing exercises, other treatments such as positive expiratory pressure (PEP therapy ) If the cause of atelectasis is bronchial obstruction from secretions, the secretions must be removed by coughing or suctioning to permit air to re-enter that portion of the lung
  • 19. Chest physical therapy (chest percussion and postural drainage) Nebulizer treatments with a bronchodilator Medication or sodium bicarbonate may be used to assist the patient in the expectoration of secretions. If respiratory care measures fail to remove the obstruction, a bronchoscopy is performed. Endotracheal intubation and mechanical ventilation may be necessary for respiratory failure
  • 20. Contd… Thoracentesis, removal of the fluid by needle aspiration, or insertion of a chest tube if cause is compression Bronchoscopy
  • 21. Nursing diagnosis Ineffective breathing pattern related to collapse of lung tissue Activity intolerance