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Atelectasis.docx

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A
abha chaorsiya

Atelectasis is the closure or collapse of alveoli caused by reduced alveolar ventilation or blockage preventing air from entering or leaving the alveoli. This causes trapped air in the alveoli to be absorbed while outside air cannot enter, resulting in collapse. Symptoms include cough, sputum production, fever, difficulty breathing, and low blood oxygen. Diagnosis is made through decreased breath sounds, chest x-ray findings of infiltrates or consolidation, and low oxygen saturation. Management involves removing secretions through coughing, suctioning, chest physical therapy, and medications to improve ventilation and re-expand the lungs.

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Atelectasis Atelectasisisthe closure orcollapse of alveoli. Causes - postoperative settingorinpeople whoare immobilizedandhave ashallow,monotonous breathingpattern. - Excesssecretionsormucus - chronicairwayobstruction Pathophysiology Atelectasismayoccurinthe adultas a resultof reducedalveolarventilationoranytype of blockage that impedesthe passage of airtoand from the alveoli thatnormallyreceiveairthroughthe bronchi and networkof airways.The trappedalveolarairbecomesabsorbedintothe bloodstream, but outside aircannotreplace the absorbedairbecause of the blockage.Asa result,the isolatedportion of the lungbecomesairlessandthe alveoli collapse. Clinical Manifestations - Cough - sputumproduction - low-grade fever. - respiratorydistress - dyspnea, - tachycardia - tachypnea - pleural pain,andcentral cyanosis(abluishskinthatisa late signof hypoxemia) - difficultybreathinginthe supine positionandisanxious. Assessment and Diagnostic Findings - Decreasedbreathsoundsandcracklesare heardover the affectedarea. - chestx-rayfindingsmayreveal patchyinfiltratesorconsolidatedareas - pulse oximetry(SpO2) may show alow saturationof hemoglobinwithoxygen(lessthan 90%). Prevention- - Change patient’spositionfrequently,especiallyfromsupine touprightposition,topromote ventilationandpreventsecretionsfromaccumulating. - Encourage earlymobilizationfrombedtochairfollowedbyearlyambulation. - Encourage appropriate deepbreathingandcoughingtomobilize secretionsandprevent themfromaccumulating. - Teach/reinforce appropriate technique forincentivespirometry. - Administerprescribedopioidsandsedativesjudiciouslytopreventrespiratorydepression. - Performpostural drainage andchestpercussion,if indicated. - Institute suctioningtoremove tracheobronchial secretions,if indicated. Management
- positive expiratorypressure orPEPtherapy(asimple maskandonewayvalve systemthat providesvaryingamountsof expiratoryresistance [usually5to 15 cm H2O]),continuousor intermittentpositive pressure-breathing(IPPB),orbronchoscopymaybe used. - the secretionsmustbe removedbycoughingorsuctioningtopermitairto re-enterthat portion of the lung. - Chestphysical therapy(chestpercussionandpostural drainage) mayalsobe usedto mobilize secretions. - Nebulizertreatmentswithabronchodilatormedicationorsodium - Bronchoscopy - Endotracheal intubationandmechanical ventilation. - Thoracentesis - surgical managementmaybe indicated.

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Atelectasis.docx

  • 1. Atelectasis Atelectasisisthe closure orcollapse of alveoli. Causes - postoperative settingorinpeople whoare immobilizedandhave ashallow,monotonous breathingpattern. - Excesssecretionsormucus - chronicairwayobstruction Pathophysiology Atelectasismayoccurinthe adultas a resultof reducedalveolarventilationoranytype of blockage that impedesthe passage of airtoand from the alveoli thatnormallyreceiveairthroughthe bronchi and networkof airways.The trappedalveolarairbecomesabsorbedintothe bloodstream, but outside aircannotreplace the absorbedairbecause of the blockage.Asa result,the isolatedportion of the lungbecomesairlessandthe alveoli collapse. Clinical Manifestations - Cough - sputumproduction - low-grade fever. - respiratorydistress - dyspnea, - tachycardia - tachypnea - pleural pain,andcentral cyanosis(abluishskinthatisa late signof hypoxemia) - difficultybreathinginthe supine positionandisanxious. Assessment and Diagnostic Findings - Decreasedbreathsoundsandcracklesare heardover the affectedarea. - chestx-rayfindingsmayreveal patchyinfiltratesorconsolidatedareas - pulse oximetry(SpO2) may show alow saturationof hemoglobinwithoxygen(lessthan 90%). Prevention- - Change patient’spositionfrequently,especiallyfromsupine touprightposition,topromote ventilationandpreventsecretionsfromaccumulating. - Encourage earlymobilizationfrombedtochairfollowedbyearlyambulation. - Encourage appropriate deepbreathingandcoughingtomobilize secretionsandprevent themfromaccumulating. - Teach/reinforce appropriate technique forincentivespirometry. - Administerprescribedopioidsandsedativesjudiciouslytopreventrespiratorydepression. - Performpostural drainage andchestpercussion,if indicated. - Institute suctioningtoremove tracheobronchial secretions,if indicated. Management
  • 2. - positive expiratorypressure orPEPtherapy(asimple maskandonewayvalve systemthat providesvaryingamountsof expiratoryresistance [usually5to 15 cm H2O]),continuousor intermittentpositive pressure-breathing(IPPB),orbronchoscopymaybe used. - the secretionsmustbe removedbycoughingorsuctioningtopermitairto re-enterthat portion of the lung. - Chestphysical therapy(chestpercussionandpostural drainage) mayalsobe usedto mobilize secretions. - Nebulizertreatmentswithabronchodilatormedicationorsodium - Bronchoscopy - Endotracheal intubationandmechanical ventilation. - Thoracentesis - surgical managementmaybe indicated.