Atelectasis is a complete or partial collapse of a lung or lobe of a lung develops when the tiny air sacs (alveoli) within the lung become deflated.

1. ATELECTASIS
Prepared by
Jenisha Adhikari
BSN

2. CONTENT
 INTRODUCTION
 CAUSES
 PATHOPHYSIOLOGY
 SIGN AND SYMPTOMS
 DIAGNOSIS
 TREATMENT
 NURSING MANAGEMENT

3. INTRODUCTION
 Atelectasis is a complete or partial collapse of
a lung or lobe of a lung develops when the tiny
air sacs (alveoli) within the lung become
deflated.

4.  The amount of lung tissue involved in
atelectasis is variable, depending on the
cause. Atelectasis can make breathing difficult
and lower oxygen particularly if lung disease is
already present. Treatment depends on the
cause and severity of the collapse.

6. Types
 Resorptive Atelectasis
 When airways are obstructed there is no further
ventilation to the lungs and beyond. In the early stages,
blood flow continues and gradually the oxygen and
nitrogen get absorbed, resulting in atelectasis.
 Resorption atelectasis is another type
of atelectasis that occurs when an obstruction in the
lungs prevents air from reaching the airways. The air is
absorbed into the surrounding areas and the alveoli
collapse

7.  Relaxation Atelectasis
 The lung is held close to the chest wall because
of the negative pressure in the pleural space.
Once the negative pressure is lost the lung tends
to recoil due to elastic properties and becomes
atelectatic. This occurs in patients with
pneumothorax and pleural effusion. In this
instance, the loss of negative pressure in the
pleura permits the lung to relax, due to elastic
recoil. There is common misconception that
atelectasis is due to compression.

8. Cont..
 Adhesive Atelectasis
 Surfactant reduces surface tension and keeps the
alveoli open. In conditions where there is loss of
surfactant, the alveoli collapse and become
atelectatic. In ARDS this occurs diffusely to both
lungs. In pulmonary embolism due to loss of
blood flow and lack of CO2, the integrity of
surfactant gets impaired.

9.  Cicatricial Atelectasis
 Alveoli gets trapped in scar and becomes
atelectatic in fibrotic disorders.
 Round Atelectasis
 An instance where the lung gets trapped by
pleural disease and is devoid of air. Classically
encountered in asbestosis

10. Pathophysiology
 Resorption or obstructive atelectasis due to
intrinsic or extrinsic airway obstruction
 Passive atelectasis from diaphragmatic
dysfunction and hypoventilation
 Compressive atelectasis from lung tissue
compression and ineffective alveolar
expansion from intra or thoracic forces
 Adhesive atelectasis due to increased surface
tension

11. CAUSES
The most common cause is post-surgical atelectasis,
characterized by
splinting, i.e. restricted breathing after abdominal surgery whereas
other
causes are;
 Smoking
 Pulmonary TB
 Mucus plug
 Foreign body
 Blood clot
 Tumor in major airway
 Injury
 Pleural effusion
 Scarring of lung tissue
 Pneumonia

12. Risk Factor
 Age — being younger than 3 or older than 60
years of age.
 Any condition that interferes with spontaneous
coughing, yawning and sighing.
 Confinement to bed with infrequent changes of
position.
 Impaired swallowing function, particularly in older
adults — aspirating secretions into the lungs is a
major source of infections.
 Lung disease, such as asthma in children, COPD,
bronchiectasis or cystic fibrosis.

13. Cont..
 Premature birth.
 Recent abdominal or chest surgery.
 Recent general anesthesia.
 Respiratory muscle weakness, due to
muscular dystrophy, spinal cord injury or
another neuromuscular condition
 Any cause of shallow breathing — including
medications and their side effects, or
mechanical limitations, such as abdominal
pain or rib fracture, for example.

14. Signs and symptoms
 May have no signs and symptoms or they may
include
 cough, but not prominent;
 chest pain (not common);
 breathing difficulty (fast and shallow);
 low oxygen saturation;
 pleural effusion (transudate type);
 cyanosis (late sign);
 increased heart rate.
 fever

15. Complication
 Low blood oxygen (hypoxemia).
 Pneumonia.
 Respiratory failure.

16. Diagnosis
 Chest X-ray
 CT scan
 Oximetry
 Bronchoscopy

17. Treatment
Treatment is directed at correcting the
underlying cause
1. Due to surgery
 Perform deep breathing exercises.
 Change your position.
 Make an effort to cough.
2. Pressure From Outside the Lungs
 If pressure from outside the lungs causes
atelectasis, then treat the cause of the pressure.
For example, if the cause is a tumor or fluid
buildup, remove the tumor or fluid. This will allow
the lung to fully expand.

18. 3. Blockage
 If a blockage causes atelectasis, you'll receive
treatment to remove the blockage or relieve it.
If the blockage is from an inhaled object, such
as a peanut, your doctor will remove it during
bronchoscopy
 If a mucus plug is blocking the airways, doctor
may use suction to remove it also Chest
clapping or percussion , Postural drainage and
several Medicines can remove the mucus.

19.  Use aerosolized respiratory treatments
(inhaled medications) to open the airway
 Treat tumor or other condition

20. Nursing Management
Assessment
 History taking
 Physical examination
 X ray

21. Cont..
Nursing Diagnosis
 Impaired Gas Exchange related to alveolar-capillary
membrane dysfunction.
 Ineffective breathing pattern related to excessive
mucus production and thick,ineffective cough.
 Impaired gas exchange related to lung volume
reduction
 Activity Intolerance related to weak body condition
secondary to increased respiratory effort.
 Risk for fluid volume deficit related to fever fluid loss,
fluid intake is less because of dyspnoea.
 Acute Pain related to lung inflammation

22. Cont..
Nursing Intervention
 Encourage the patient to perform coughing and deep-
breathing exercises every 1 to 2 hours.
 Help the patient use an incentive spirometer to
encourage deep breathing.
 Gently reposition the patient often and help them walk
as soon as possible.
 Administer adequate analgesics to control pain.
 Humidify inspired air and encourage adequate fluid
intake to mobilize secretions.
 Provide suctioning as needed for patients who are
intubated or unable to clear their own secretions.

23. Cont..
 Administer sedatives with care because these medications
depress respirations and cough reflex.
 Use postural drainage and chest percussion to remove
secretions.
 Offer reassurance and emotional support because the
patient’s limited breathing capacity may frighten him.
 Assess breath sounds and respiratory status frequently.
Report any changes immediately.
 Evaluate the patient’s ability to perform bronchial hygiene.
 Monitor pulse oximetry readings and ABG values for evidence
of hypoxia.
 Demonstrate comfort measures to promote relaxation and
conserve energy.