Adult Medical-Surgical Nursing Respiratory Module: Atelectasis

Atelectasis Atelectasis is the collapse of alveoli which become airless VQ ratio = < 1 (ventilation/ perfusion ratio) Perfusion of alveoli (Q) is fine but ventilation (V) is impaired (see Introductory Lecture)

Atelectasis: Aetiology/ Pre-disposing Risk Factors Immobility → shallow respirations Pain: fear of deep - breathing / coughing following surgery or trauma Elderly patients: less energy to cough, weaker muscles, debility Unconscious or stroke patients: immobility and risk of aspirating secretions/ fluids Smoking Patients with COPD and Bronchial Asthma

Atelectasis: Clinical Manifestations DyspnoeaOrthopnoeaTachypnoea Pleuritic chest pain (sharp on inspiration) Tachycardia Cough (dry or productive) Fever if infection super-imposed

Atelectasis: Diagnosis Patient history Auscultation (airless areas) Chest Xray (opaque areas of alveoli)

Atelectasis: Prevention (Nursing Role) Regular change of position (2-hourly) Deep breathing and leg exercises (pre- and post-op) Early ambulation post-op Pain relief prior to physio (pillow to hold during exercises post-op) Adequate fluid intake to encourage expectoration

Atelectasis: Treatment and Nursing Role Breathing exercises/ physio SpirometerMucolytics Adequate hydration Bronchodilators Antibiotics to prevent pneumonia ABG and pulse oximetry