Angelite Nurses: Atelectasis

Atelectasis

General information

Collapse of part or all of a lung due to bronchial obstruction
May be caused by intrabronchial obstruction (secretions, tumors, bronchospasm, foreign bodies); extrabronchial compression (tumors, enlarged lymph nodes); or endobronchial disease (bronchogenic carcinoma, inflammatory structures)

Assessment findings

Signs and symptoms may be absent depending upon degree of collapse and rapidity with which bronchial obstruction occurs
Dyspnea, decreased breath sounds on affected side, decreased respiratory excursion, dullness to flatness upon percussion over affected area
Cyanosis, tachycardia, tachypnea, elevated temperature, weakness, pain over affected area
Diagnostic tests

Bronchoscopy: may or may not reveal an obstruction
Chest x-ray shows diminished size of affected lung and lack of radiance over atelectic area
pO₂ decreased

Nursing interventions (prevention of atelectasis in hospitalized clients is an important nursing responsibility)

Turn and reposition every 1-2 hours while client is bedridden or obtunded.
Encourage mobility (if permitted).
Promote liquification and removal of secretions.
Avoid administration of large doses of sedatives and opiates that depress respiration and cough reflex.
Prevent abdominal distension.
Administer prophylactic antibiotics as ordered to prevent respiratory infection.

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