Respiratory condition

1. ESTHER CHIRWA

2. INTRODUCTION
Atelectasis is an abnormal condition characterized by the
collapse of lung tissue, preventing the respiratory exchange of
carbon dioxide and oxygen. This condition prevents normal
oxygen absorption to healthy tissues.

3. DEFINITION
• It is a respiratory condition in which there is lack of
gas exchange within alveoli, due to alveolar collapse
caused by several medical conditions which can affect
part or all of one lungs characterized by dyspnea,
chest pain ,nose flaring, cyanosis.
• A collapsed or airless state of the lung, which may be
acute or chronic and may involve all or part of the lung

4. CLASSIFICATION
Atelectasis may be an acute or chronic condition
• Acute atelectasis, the lungs has recently
collapsed and is primarily notable only for
airlessness
• Chronic atelectasis, the affected area is often
characterized by infection, widening of the
bronchi (bronchiectasis)destruction and scarring
(fibrosis)

5. CAUSES /PREDISPOSING FACTORS
• Deficiency or effectiveness in surfactant in premature
babies.(RDS)
• Injury to the chest e.g. falls, car accidents
• Excessive oxygen therapy
• Mucus plug: accumulation of mucus in the airway ,often
occurring during and after surgery due to inability of
patient to cough out
• Tumors :which can narrow the airway
• Congenital anomalies of the bronchiole

6. • Foreign bodies: children are most likely to inhale an
object ,such as a peanut or small toy part which will
broke the airway
• It can also occur during suction due to air being
withdrawn from the lungs
• Narrowing of major airways from disease: chronic
infections including fungal infection ,tuberculosis,
and other diseases scar and constrict mayor airway

7. DIAGNOSIS
• History will reveal the predisposing factor
• Chest x-ray it will show lobar collapse with dense tissue
and decreased size of affected lungs
•
• Computer tomography will show the affected part
• Bronchoscopy will show the inflamed alveolar
• Oxymeter will show decreased oxygen in the body

8. Signs and symptoms
 Cough ( not prominent) due to irritation of the air way
 Chest pain due to inflammation
 Dyspnea due to airway obstruction
 Fever due to infection
 Tachycardia due to hypoxia, as the heart attempts to compensate
 Fatigue due to low oxygen in the blood
 .Nasal flaring due to reduce oxgyen

9. TREATMENT
Treatment is directed at correcting the cause.
• ANTIBIOTICS; Amoxicillin, Erythromycin
• CORTICOSTEROIDS;Hydrocortisone,Prednisolone
• ANALGESICS; Paracetamol,
• OXYGEN THERAPY; 1 to 2 litres/min
• SURGERY; Lobectomy
• Post surgical atelectasis is treated by physiotherapy, focusing
on deep breathing and encouraging coughing

10. Nursing care
Objectives
 Maintain patent airway, ventilation and tissues
oxygenation
 To prevent complication
 To promote rest

11. Environment
 Patient will be nursed in a well ventilated room to avoid other respiratory
infections
 The patient will be nursed in a well lit environment for easy observations
 The environment should include e oxygen apparatus to use the patient
becomes dyspneic
 The nurse should include in the room the drip stands to use when need arises

12. Position
• The patient will be nurse in fowler position to promote
lung expansion and relieve dyspnea
• I will change the patient 2 hourly to prevent development
of pressure sores
• As the patient’s condition improves, I will let the patient
adopt any position of comfort to promote rest

13. .I will nurse the patient in a quiet room to promote rest
.I will play the radio at low volume to promote rest
.I will answer all phone calls promptly to prevent disturbing
the patient there by promote rest
.I will do related procedures in blocks to promote rest
.I will administer prescribed analgesics in order to promote
rest
.I will ensure that squeaking trolleys a oiled to prevent noise
and there by promote rest

14. .I will do vital sign and BP to act as the base line data
in order to know if the condition is improving or
deteriorating
.I will observe for cyanosis if improving or getting
worse and give oxygen therapy when necessary
.I will observe Dyspnea if present will prop up the
patient to promote lung expansion and there by
relieve dyspnea
.I will observe the pressure area to detect on set of
pressure sore development

15. .I will observe the sputum for color amount and
consistency to detect hemoptysis and report the
physician
.I will observe the patient’s facial expressions to
detect
pain and administer prescribed analgesics like
panadol
.I will observe the feeding pattern of my patient and
take measures like giving small frequent meals to
promote appetite
.I will observe the respirations to detect tachycardia
and report accordingly

16. .I will explain the disease process to the mother in order
to raise the knowledge levels and thereby alley anxiety
.I will encourage the patient’s mother to ask question
and I will answer accordingly those I cant answer I will
refer to the physician
.I will explain all procedures to my patient’s parents in
order to allay anxiety
.I will tell the mother that as health workers we doing
everything possible to gain cooperation.

17. .I will involve the loved ones in his care in order for
him not to feel neglected
.I will provide diversional therapy such as toys in
order to shift the patient’s mind from the hospital
routine and his condition
.I will involve my patient’s mother in planning care in
order for him not to feel left out
.I will explain to the mother that as the health care
team we re doing everything possible to ensure that
he get better in order to promote co-operation

18. .I will offer baths to my patient in order to remove dead
epithelium and promote comfort
.I will do hair care to promote self esteem and also
prevent pediculosis
.
.I will do nail care to prevent auto infection
.I will do mouth care to prevent halitosis
Any soiled linen and clothes will be changed to
promote comfort

19. • I will provide a lot of fluids and roughage to prevent
constipation.
• I will prove copious fluids in order to promote .renal
wash out and there by prevent renal
problems.

20. .i will provide energy giving foods like nshima to
provide the energy needed for the metabolic
processes
.I will provide protein foods like fish and beans to
promote replacement of worn out tissues
Vegetables and fruits will be provided to raise the
immunity and promote skin and mucous
membrane integrity

21. • I will provide a lot of oral fluids to prevent
dehydration due to excessive sweating and
promote bringing up of phlegm
• I will serve small frequent meals to promote
appetite
• I will allow the mother to bring food preferred by
the patient in order to promote appetite
• I will do regular mouth washes in order to
promote appetite

22. • If my patient is confined to bed i will do passive
exercises like limb movement and massage in order to
prevent muscle atrophy and promote blood circulation
• I will encourage early ambulation as soon as the
condition permits in order to prevent deep vein
thrombosis and other complications of immobility

23. • I will administer prescribed analgesic like panadol at the
right time to promote rest
• I will give prescribed drugs in order to promote recovery
• I will ensure that the drugs are swallowed in my presence
to promote recovery
• I will ensure that I record when the drugs are given to
prevent drug over dose.

24. • I will educate the patient and its mother about his condition in
order to create awareness and prevent recurrence of the condition
• I will explain the need for taking the medication in order to
promote compliance
• I will educate the patient about the sign and symptoms of the
condition for early diagnosis and treatment thereby preventing
complications
• I will talk to the patient about the need to take a balanced diet
using locally available foods in order to boost the immunity
• I will encourage the mother to remove the toy parts in the
environment where the baby is playing to prevent the baby from
swallowing.

25. • I will talk to the patient and his mother
about the need to take a balanced diet
using locally available foods in order to
boost the immunity

26. complications
 Low blood oxygen (hypoxemia)
 Lung scaring
 Pneumonia
 Respiratory failure