Atelectasis in surgical nursing slide.pptx

This document contains information on atelectasis which is the collapse or closure of the lung as a result of no or reduced gas exchange. It contains the definition, causes, clinical manifestations, pathophysiology, medical and pharmacological management as well as nursing interventions.

1. ATELECTASIS 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. 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.

2. Risk Factors Obstruction of an airway Diminished distention of alveoli Extrinsic compression on an airway ( eg , compression due to an enlarged or aberrant vessel) Retained secretions Anaesthesia or sedation Increased abdominal pressure

3. 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 hence i solated portion of the lung becomes airless and the alveoli collapse. Excessive pressure on the lung tissue r estricts normal lung expansion on inspiration, the lung becomes airless for prolong period and alveolar collapse

4. Clinical Manifestations Cough with sputum production. L ow-grade fever. Marked respiratory distress Dyspnoea Tachycardia Tachypnoea Pleural pain C entral cyanosis Difficulty breathing in the supine position

5. 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.

6. 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 Thoracentesis, removal of the fluid by needle aspiration, or insertion of a chest tube if cause is compression

7. 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 Perform postural drainage and chest percussion, if indicated. Administer prescribed Opioids and sedatives judiciously to prevent respiratory depression.

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