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Atelectasis

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short description on atelectasis

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Atelectasis

  1. 1. Atelectasis
  2. 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. 3. Contd…  Atelectasis may be acute or chronic  The most commonly described atelectasis is acute atelectasis, which occurs frequently in the postoperative setting or in people who are immobilized and have a shallow, monotonous breathing pattern.
  4. 4. Etiology  Obstruction of an airway  Diminished distention of alveoli
  5. 5. 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
  6. 6. 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
  7. 7. 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
  8. 8. 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
  9. 9. 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.
  10. 10.  Excessive pressure on the lung tissue  Restricts normal lung expansion on inspiration  Becomes airless for prolong period  Alveolar colapse
  11. 11. 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
  12. 12. 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.
  13. 13. 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
  14. 14. 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.
  15. 15. 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.
  16. 16. 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
  17. 17.  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
  18. 18. Contd…  Thoracentesis, removal of the fluid by needle aspiration, or insertion of a chest tube if cause is compression  Bronchoscopy
  19. 19. Nursing diagnosis  Ineffective breathing pattern related to collapse of lung tissue  Activity intolerance
  20. 20. Thank You

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