Atelectasis

OM VERMA
ASSISTANT PROFESSOR
RELIANCE INSTITUTE OF NURSING

1. PRESENTED BY
MR.OM VERMA
ASSISTANT PROFESSOR
RELIANCE INSTITUTE OF NURSING
DHAMTARI (C.G)
ATELECTASIS

2. defination
Atelectasisis 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
according to lippincott
Atelectasisis the collapse of alveoli or lung tissue.
according to lewis
It develops when the alveoli becomes airless from
absorption of their air without replacement of the air
with breathing.
according to Luckmannand Sorensen's

3. Con..
Atelectasisis a complete or partial collapse of the
entire lung or area (lobe) of the lung. It occurs when
the tiny air sacs (alveoli) then lead to atelectectasis.
 according to brunnerand suddarth

5. Etiology
Obstruction of an airway
Diminished distention of alveoli

6. 1. Airway obstruction
Airway obstruction due to a mucous plug or other
airway secretions, such as with bronchiolitis
Bronchospasm, airway secretions and airway
inflammation in patients with asthma
Abnormal airway secretions in cystic fibrosis
Abnormal airway clearance, such as with ciliary(
defect cilia lining the respiratory tract ) dyskinesia
syndrom

7. 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
Cardiomegalyor enlarged pulmonary vessels that
compress adjacent airways

8. 2. causes of diminished alveolar distention
Small or dysmorphicchest wall
Severe scoliosis immune system (abnormal curve and
inflammation) eats away at the protective covering of nerve
Neuromuscular diseases example cerebrovascularaccident
(damage to brain from iterruptionof its blood supply ) ,Parkinson
disease (is a braindisorderthat leads to shaking, stiffness, and
difficulty with walking, balance, and coordination.) ,
multiple sclerosis (is a potentially disabling disease of the
brain and spinal cord (central nervous system). In Myelin Sheth,
the immune system attacks the protective sheath (myelin) that
covers nerve fibers and causes communication problems between
your brain and the rest of your body. )

9. Anesthesia or sedation resulting in lack of
oxygen of blood a major causes is collapsof lungs
tissue
Pain from upper abdominal surgery
Abdominal distention
Chest wall or upper abdominal pain

10. Etiology of atelectasis
Alteredbreathingpatterns
Pain,alterationsinsmallairwayfunction
Anesthesiaorsedation
Increasedabdominalpressure=causescranial
shiftofthediaphragmleadreductionoflungs
volume.
Reducedlungvolumesduetomusculoskeletal
(Severescoliosis)orneurologicdisorders
Painfromupperabdominalsurgery

11. Contd…
Restrictivedefects,andspecificsurgical
procedures(eg,upperabdominal,thoracic,or
openheartsurgery).
Persistentlowlungvolumes
Secretionsoramassobstructingorimpeding
airflowandcompressionoflungtissue
Bronchospasm, airway secretions and
airway inflammation in patients with
asthma
Abnormal airway secretions in cystic fibrosis

12. Contd….
Abnormal airway clearance, such as with ciliary
dyskinesiasyndrome ( uncontrolled involuntary
muscle movement )
Airway foreign body
Excessive pressure on the lung tissue (pleural
effusion, (pneumothorax= condition occure
when air leaks into the space between the
lungs and chest wall ), ( hemothorax=
accumulation of blood in pleural cavity)
Tumor growth within the thorax, or an elevated
diaphragm

13. 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.

14.  Excessive pressure on the lung tissue
Restricts normal lung expansion on inspiration
 Becomes airless for prolong period
Then lead to
Alveolar collapse

15. 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

16. 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.

18. managment
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 spirometryor voluntary deep
breathing
Directed cough, suctioning, aerosol nebulizer
treatments followed by chest physical therapy
Postural Drainage and chest percussion, or
bronchoscopy

19. 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.

20. Contd…
Administer prescribed Opioidsand sedatives
judiciously to prevent respiratory depression.
Perform postural drainage and chest percussion,
if indicated.
Institute suctioning to remove tracheobronchial
secretions, if indicated.

21. Management
The goal in treating the patient with atelectasisis 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 atelectasisis bronchial obstruction
from secretions, the secretions must be removed by
coughing or suctioning to permit air to re-enter that
portion of the lung

22. Pharmachologicalmanagement
Bronchodilators may be used to encourage sputum
expectoration; if underlying airflow is present, these
agents may also improve ventilation. Some patients
may require broad-spectrum antibiotics to treat the
underlying infections, which may occur because of
bronchial obstruction.N-acetylcysteineaerosol is
not routinely recommended because of the risk of
bronchoconstrictionand the lack of documented
efficacy.


23. Drugs
Mucolyticdissolves thick mucus and usually used to
help respiratory difficulty .
Ambroxol,acetylcysteine
bronchodilators

24. 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.

25. SURGICAL MANAGMENT…
Thoracentesis, removal of the fluid by needle
aspiration, or insertion of a chest tube if cause is
compression
Surgery
Removal of airway obstructions may be done by
suctioning mucus or by bronchoscopy. During
bronchoscopy, the doctor gently guides a flexible tube
down your throat to clear your airways.
If a tumor is causing the atelectasis, treatment may
involve removal or shrinkage of the tumor with surgery,
with or without other cancer therapies (chemotherapy or
radiation).

26. If respiratory care measures fail to remove the
obstruction, a bronchoscopyis performed.
Endotrachealintubation and mechanical
ventilationmay be necessary for respiratory failure

27. complication
complications of atelectasis?
Acutepneumonia.
Bronchiectasis.
Hypoxemia and respiratory failure.
Sepsis.
Pleural effusionand empyema.

28. Nursing diagnosis
Ineffective breathing pattern related to
collapse of lung tissue
Activity intolerance

29. Thank You