Atelectasis

Atelectasis (at-uh-LEK-tuh-sis) is a complete or partial collapse of the entire lung or area (lobe) of the lung.

1. Atelectasis Mrs. Nibi R Benjamin Asst. prof.

2. INTRODUCTION Atelectasis is of Greek origin and means lack of stretch . It may be acute or chronic.

3. Definition Atelectasis is a is a collapse of the airways in the lungs collapse occur from airway obstruction and diminished alveolar distension. It is defined as the collapse or closure of the lungs resulting in reduce or absent gas exchange . It may affect part or all of the one lungs. It is also known as the closure or airless condition of the lungs with incomplete expansion.

4. Causes Congenital / primary atelectasis preterm/ lbw baby. Due to immaturity of respiratory of muscle alveolar ducts abnormality and pulmonary disorders. 2. Acquired or secondary atelectasis : Bronchial obstruction due to foreign body Excessive secretions Mucous plugs Tumors Enlargement of lymph nodesor heart Pleural effusion. Pneumothorax

5. TYPES ↓ TYPES OBSTRUCTIVE COLLAPSE COMPRESSIVE CICATRICIAL ADHESIVE COLLAPSE

6. Sign and symptoms. Fever Dyspnea Wheezing Cyanosis Sign of mediastinal shift to the affected side Elevation of the diaphragm of the involved hemothorax Diminished or absent breath sound on the atelectatic side Hypotension Shock Tachycardia Non productive cough

7. Diagnostic evaluation History taking Physical examination Chest x ray CBP CVP Sputum test AFB staining PET SCAN Bronchoscopy

8. Pattern of atelectasis

9. Treatment Treatment will depend on the cause of the atelectasis Antibiotics for pneumonia Chest physiotherapy Positive pressure breathing Incentive spirometer use Bronchoscopic aspiration

10. Complication Hypoxemia Respiratory failure Emphysema Infection Fibrosis

11. Nursing management Early recognition of atelectasis • Semi fowlers positioning should be maintained. • oxygen therapy. Increased humidity in the environment can prevent the drying of secretions and the formations of bronchial plugs. • Prevent secondary infections. • Prevent respiratory distress.

12. Nursing management Ineffective breathing pattern related to: • Hypoxia/inflammatory process Neuromuscular impairment. Pain Musculoskeletal impairment Tracheobronchial obstruction Perception or cognitive impairment Anxiety Decreased energy and fatigue Decreased lung expansion

13. Ineffective airway clearance related to: –stasis of secretions associated with decreased activity, depressed ciliary function resulting from the effect of anesthesia, and a weak cough effort –increased secretions associated with irritation of the respiratory tract (can result from inhalation anesthetics and endotracheal intubation)

14. Impaired gas exchange related to ventilation/perfusion imbalances associated with atelectasis/hypoventilation or ineffective clearance of secretions. • Fluid volume excess related to pulmonary interstitium &alveoli as manifested by respiratory rate variation /by auscultation / investigation (chest)

15. Ineffective tissue perfusion r/t compromised blood flow r/t respiratory distress syndrome cyanosis of hands, feet, and around mouth. Ineffective thermoregulation r/t immature compensation for changes in environmental temperature. Imbalanced nutrition status less than body requirements r/t poor feeding behavior Risk for impaired parent-infant attachment r/t interruption of bonding process.