Atelectasis

  1. General information
    1. Collapse of part or all of a lung due to bronchial obstruction
    2. May be caused by intrabronchial obstruction (secretions, tumors, bronchospasm, foreign bodies); extrabronchial compression (tumors, enlarged lymph nodes); or endobronchial disease (bronchogenic carcinoma, inflammatory structures)
  2. Assessment findings
    1. Signs and symptoms may be absent depending upon degree of collapse and rapidity with which bronchial obstruction occurs
    2. Dyspnea, decreased breath sounds on affected side, decreased respiratory excursion, dullness to flatness upon percussion over affected area
    3. Cyanosis, tachycardia, tachypnea, elevated temperature, weakness, pain over affected area
    4. Diagnostic tests
      1. Bronchoscopy: may or may not reveal an obstruction
      2. Chest x-ray shows diminished size of affected lung and lack of radiance over atelectic area
      3. pO2 decreased
  3. Nursing interventions (prevention of atelectasis in hospitalized clients is an important nursing responsibility)
    1. Turn and reposition every 1-2 hours while client is bedridden or obtunded.
    2. Encourage mobility (if permitted).
    3. Promote liquification and removal of secretions.
    4. Avoid administration of large doses of sedatives and opiates that depress respiration and cough reflex.
    5. Prevent abdominal distension.
    6. Administer prophylactic antibiotics as ordered to prevent respiratory infection.

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