1. Atelectasis

2. Introduction
 Atelectasis is 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.

4. Contd…
 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.

5. Etiology
 Obstruction of an airway
 Diminished distention of alveoli

6. Contd
 Airway foreign body
 Extrinsic compression on an airway (eg,
compression due to an enlarged or aberrant vessel)
 Enlarged lymph nodes that compress the airway
 Masses in the chest that compress the airway or
alveoli
 Cardiomegaly or enlarged pulmonary vessels that
compress adjacent airways

7. Etiology of atelectasis
 Altered breathing patterns
 Retained secretions
 Pain, alterations in small airway function
 Anesthesia or sedation
 Increased abdominal pressure
 Reduced lung volumes due to musculoskeletal
(Severe scoliosis) or neurologic disorders
 Pain from upper abdominal surgery

8. Contd…
 Restrictive defects, and specific surgical
procedures (eg, upper abdominal, thoracic, or
open heart surgery).
 Persistent low lung volumes
 Secretions or a mass obstructing or impeding
airflow and compression of lung tissue
 Bronchospasm, airway secretions and
airway inflammation in patients with
asthma
 Abnormal airway secretions in cystic fibrosis

9. Contd….
 Abnormal airway clearance, such as with ciliary
dyskinesia syndrome
 Airway foreign body
 Excessive pressure on the lung tissue (pleural
effusion, pneumothorax, hemothorax)
 Tumor growth within the thorax, or an elevated
diaphragm

10. 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
 Isolated portion of the lung becomes airless and the
alveoli collapse.

11.  Excessive pressure on the lung tissue
 Restricts normal lung expansion on inspiration
 Becomes airless for prolong period
 Alveolar colapse

12. Clinical Manifestations
 Cough, sputum production, and low-grade fever.
 Marked respiratory distress
 Dyspnea, tachycardia,
 Tachypnea, pleural pain, and central cyanosis
 Difficulty breathing in the supine position
 Anxious

13. 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.

15. 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
 Postural Drainage and chest percussion, or
bronchoscopy

16. Contd..
 Change patient’s position frequently, especially
from supine to upright position, to promote
ventilation and prevent secretions from
accumulating.
 Encourage early mobilization from bed to chair
followed by early ambulation.
 Encourage appropriate deep breathing and
coughing to mobilize secretions and prevent
them from accumulating.

17. Contd…
 Administer prescribed Opioids and sedatives
judiciously to prevent respiratory depression.
 Perform postural drainage and chest percussion,
if indicated.
 Institute suctioning to remove tracheobronchial
secretions, if indicated.

18. 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

19.  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

20. Contd…
 Thoracentesis, removal of the fluid by needle
aspiration, or insertion of a chest tube if cause is
compression
 Bronchoscopy

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

22. Thank You