At Elect As Is
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ATELECTASIS
FAMADOR O. GENALDO, MD, RN
08/03/09
1
ATELECTASIS • The closure or collapse of the alveoli • Most commonly described in relation to x-ray findings and clinical signs and symptoms • Maybe acute or chronic
08/03/09
2
ACUTE ATELECTASIS occurs frequently in the postoperative setting or in people who are immobilized and have a shallow, monotonous breathing pattern. CHRONIC ATELECTASIS Observed in patients with chronic airway obstruction that impedes or blocks air flow to an area of the lung. 08/03/09
3
Pathophysiology Atelectasis may occur as a result of reduced alveolar ventilation or any type of blockage that impedes passage of air to and from the alveoli that normally receive air through the bronchi and network of airways.
08/03/09
4
The trapped alveolar air becomes absorbed into the bloodstream, but outside air cannot replace absorbed air because of the blockage. Thus, the isolated portion of the lung becomes airless and the alveoli collapse.
08/03/09
5
08/03/09
6
Signs and Symptoms • • • • • • • •
Cough Sputum production Low grade fever Dyspnea Tachycardia Tachypnea Pleural pain Central cyanosis (a bluish skin hue – sign of hypoxemia) 08/03/09
7
Medical Management • • • • •
Bronchodilators Bronchoscopy Thoracentesis Cryotheraphy Laser Therapy
08/03/09
8
08/03/09
9
Nursing Management • Frequent turning. Change patient’s position frequently, especially from supine to upright position, to promote ventilation and prevent secretions from accumulating. • Early mobilization Encourage early mobilization from bed to chair followed by early ambulation. 08/03/09
10
Lung Volume Expansion Exercises • Deep Breathing Exercises (every 2 hours) Encourage appropriate deep breathing and coughing to mobilize secretions and prevent them from accumulating. Teach/reinforce appropriate technique for spirometry. • Secretion Management (suctioning, aerosol nebulization, chest percussion, postural drainage)
08/03/09
11
Administer opiods and sedatives cautiously to prevent respiratory depression.
08/03/09
12
FAMADOR O. GENALDO, MD, RN
08/03/09
1
ATELECTASIS • The closure or collapse of the alveoli • Most commonly described in relation to x-ray findings and clinical signs and symptoms • Maybe acute or chronic
08/03/09
2
ACUTE ATELECTASIS occurs frequently in the postoperative setting or in people who are immobilized and have a shallow, monotonous breathing pattern. CHRONIC ATELECTASIS Observed in patients with chronic airway obstruction that impedes or blocks air flow to an area of the lung. 08/03/09
3
Pathophysiology Atelectasis may occur as a result of reduced alveolar ventilation or any type of blockage that impedes passage of air to and from the alveoli that normally receive air through the bronchi and network of airways.
08/03/09
4
The trapped alveolar air becomes absorbed into the bloodstream, but outside air cannot replace absorbed air because of the blockage. Thus, the isolated portion of the lung becomes airless and the alveoli collapse.
08/03/09
5
08/03/09
6
Signs and Symptoms • • • • • • • •
Cough Sputum production Low grade fever Dyspnea Tachycardia Tachypnea Pleural pain Central cyanosis (a bluish skin hue – sign of hypoxemia) 08/03/09
7
Medical Management • • • • •
Bronchodilators Bronchoscopy Thoracentesis Cryotheraphy Laser Therapy
08/03/09
8
08/03/09
9
Nursing Management • Frequent turning. Change patient’s position frequently, especially from supine to upright position, to promote ventilation and prevent secretions from accumulating. • Early mobilization Encourage early mobilization from bed to chair followed by early ambulation. 08/03/09
10
Lung Volume Expansion Exercises • Deep Breathing Exercises (every 2 hours) Encourage appropriate deep breathing and coughing to mobilize secretions and prevent them from accumulating. Teach/reinforce appropriate technique for spirometry. • Secretion Management (suctioning, aerosol nebulization, chest percussion, postural drainage)
08/03/09
11
Administer opiods and sedatives cautiously to prevent respiratory depression.
08/03/09
12
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