الانخماص الرئوي

Definition

Atelectasis is collapse of alveoli in part of the lung, so it no longer takes part in gas exchange.

Causes

• Post-operative: shallow breathing from pain, anaesthesia and immobility (most common)
• Bronchial obstruction by secretions, a foreign body or tumour
• Compression by pleural fluid or air

Symptoms

• Tachypnoea and dyspnoea
• Reduced breath sounds over the area
• Low-grade fever in the first post-operative days
• Low saturation

Diagnosis

Examination and chest X-ray.

Treatment and prevention

• Incentive spirometry and deep breaths hourly while awake
• Splinted coughing with a pillow over the wound
• Early mobilisation and position changes
• Adequate analgesia
• Treat the cause, such as suctioning or bronchoscopy

Nursing care

• Pre-operative teaching of breathing exercises
• Monitor saturation, temperature and breath sounds

Exam point

Key post-operative prevention: deep breathing, coughing and early mobility.