Atelektaza
Charakterystyka, pielęgnacja i opieka

Atelektaza to częściowe lub całkowite zapadnięcie się pęcherzyków płucnych, prowadzące do utraty objętości płuca i zaburzenia wymiany gazowej, co skutkuje hipoksemią i dusznością. Wyróżnia się trzy typy atelektazy: kompresyjną, resorpcyjną/obturacyjną oraz związaną z zaburzeniami surfaktantu. Pooperacyjna atelektaza rozwija się zwykle w ciągu 72 godzin po znieczuleniu ogólnym i jest związana z ograniczeniem głębokości oddechu oraz zaleganiem wydzieliny. Czynniki ryzyka obejmują choroby układu sercowo-naczyniowego, POChP, choroby nerwowo-mięśniowe, niewydolność nerek, nowotwory, unieruchomienie oraz ból pooperacyjny. Diagnostyka opiera się na badaniu fizykalnym (osłabione szmery oddechowe, trzeszczenia, przesunięcie tchawicy), monitorowaniu saturacji (pulsoksymetria) oraz obrazowaniu radiologicznym (RTG, TK). Kluczowe diagnozy pielęgniarskie to zaburzenie wymiany gazowej, nieskuteczne oczyszczanie dróg oddechowych, nieskuteczny wzór oddychania, ryzyko infekcji oraz ból ograniczający oddychanie.

Charakterystyka atelektazy (Atelectasis)

Atelektaza (atelectasis) to stan charakteryzujący się częściowym lub całkowitym zapadnięciem się pęcherzyków płucnych (alveoli), co prowadzi do utraty objętości płuca i zaburzenia wymiany gazowej. W rezultacie dochodzi do zmniejszonego dostarczania tlenu do krwiobiegu, co może powodować duszność oraz dyskomfort u pacjenta12. Atelektaza jest jednym z najczęstszych powikłań oddechowych po zabiegach operacyjnych, występującym nawet u 90% pacjentów, którzy otrzymali znieczulenie ogólne34.

Wyróżnia się trzy główne rodzaje atelektazy5:

  • Kompresyjna – spowodowana uciskiem na tkankę płucną z zewnątrz (przez płyn, powietrze, krew lub guz)
  • Resorpcyjna/obturacyjna – wywołana zablokowaniem przepływu powietrza i wchłonięciem powietrza z pęcherzyków płucnych
  • Związana z zaburzeniami surfaktantu płucnego – wynikająca z nieprawidłowej produkcji lub funkcji surfaktantu

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W przypadku atelektazy pooperacyjnej, która rozwija się zazwyczaj w ciągu 72 godzin po zastosowaniu znieczulenia ogólnego, dochodzi do zmiany wzorca oddychania pacjenta, co prowadzi do upośledzenia wymiany gazowej8. Zmniejszona głębokość oddychania oraz brak możliwości efektywnego odkrztuszania wydzieliny mogą przyczyniać się do powstania niedodmy (atelektazy)9.

Czynniki ryzyka

Pacjenci przyjmowani do szpitala często posiadają różnorodne czynniki ryzyka predysponujące do rozwoju atelektazy. Do najważniejszych należą1011:

  • Choroby układu sercowo-naczyniowego
  • Choroby płuc, szczególnie przewlekła obturacyjna choroba płuc (POChP)
  • Choroby nerwowo-mięśniowe
  • Niewydolność nerek
  • Nowotwory
  • Choroby autoimmunologiczne
  • Znieczulenie ogólne podczas zabiegu operacyjnego
  • Unieruchomienie lub zbyt mała aktywność fizyczna
  • Ból pooperacyjny ograniczający głębokie oddychanie

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Ocena pielęgniarska

Kompleksowa ocena pielęgniarska stanowi podstawę dla opracowania indywidualnego planu opieki dla pacjentów z atelektazą. Powinna ona obejmować określenie czynników przyczyniających się do atelektazy oraz aktualnego stanu fizycznego i psychicznego pacjenta13.

Badanie fizykalne

Podczas badania fizykalnego pielęgniarka powinna zwrócić uwagę na1415:

  • Parametry życiowe: częstość oddechów, głębokość oddychania, saturacja, tętno, ciśnienie krwi, temperatura
  • Osłuchiwanie płuc: osłabione szmery oddechowe, obecność szmerów oskrzelowych lub rurowych, trzeszczenia
  • Wykładniki niewydolności oddechowej: użycie dodatkowych mięśni oddechowych, sinica, niepokój lub pobudzenie
  • Obserwacja ruchomości klatki piersiowej i przepony
  • Przesunięcie tchawicy w stronę zajętą

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Monitorowanie saturacji tlenem poprzez pulsoksymetrię pozwala ocenić poziom natlenienia krwi. Badania radiologiczne, takie jak RTG klatki piersiowej czy tomografia komputerowa, mogą być wykonywane w celu określenia zakresu atelektazy17.

Diagnozy pielęgniarskie

Na podstawie przeprowadzonej oceny można sformułować następujące diagnozy pielęgniarskie1819:

  • Zaburzenie wymiany gazowej związane ze zmniejszoną powierzchnią oddechową płuc wskutek zapadnięcia się pęcherzyków płucnych
  • Nieskuteczne oczyszczanie dróg oddechowych związane z obecnością wydzieliny i niemożnością efektywnego odkrztuszania
  • Nieskuteczny wzór oddychania związany z bólem, zmniejszoną głębokością oddychania lub obturacją
  • Nietolerancja aktywności związana z hipoksemią i zwiększonym wysiłkiem oddechowym
  • Ryzyko infekcji związane ze stagnacją wydzieliny oskrzelowej
  • Ból ograniczający efektywne oddychanie i kaszel
  • Lęk związany z dusznością i hospitalizacją

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Interwencje pielęgniarskie

Interwencje pielęgniarskie w leczeniu atelektazy są działaniami terapeutycznymi podejmowanymi przez pielęgniarkę w celu realizacji planu opieki nad pacjentem. Przyczyniają się one do komfortu pacjenta, rekonwalescencji i zapobiegania dalszym powikłaniom21.

Poprawa rozprężenia płuc

Kluczowym elementem leczenia atelektazy jest przywrócenie prawidłowego rozprężenia płuc. W tym celu stosuje się2223:

  • Głębokie oddychanie i ćwiczenia kaszlu – nauczenie pacjenta technik głębokiego oddychania i efektywnego kaszlu pomaga w rozprężeniu płuc i mobilizacji wydzieliny
  • Spirometrię zachęcającą (incentive spirometry) – urządzenie wspierające głębokie wdechy, które pomaga utrzymać drogi oddechowe otwarte i zapobiegać zapadaniu się pęcherzyków płucnych
  • Wczesną mobilizację pacjenta – zachęcanie do siadania na brzegu łóżka i chodzenia po zabiegu operacyjnym zwiększa przepływ powietrza w płucach
  • Zmianę pozycji ciała – regularna zmiana pozycji (co 2 godziny) ułatwia drenaż wydzieliny i poprawia wentylację różnych obszarów płuc

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Fizjoterapia oddechowa

Fizjoterapia oddechowa jest tradycyjną terapią pierwszego rzutu w leczeniu atelektazy. Obejmuje ona2627:

  • Oklepywanie klatki piersiowej (perkusję) – delikatne uderzanie w plecy lub bok pacjenta, pomagające w poluzowaniu i przemieszczaniu wydzieliny z płuc
  • Drenaż ułożeniowy – układanie pacjenta w określonych pozycjach, które ułatwiają odpływ wydzieliny; czasem głowa znajduje się niżej niż klatka piersiowa
  • Techniki wibracyjne – zastosowanie wibracji do poluzowania wydzieliny zalegającej w drogach oddechowych
  • Techniki wymuszonego wydechu – specjalne techniki oddechowe wspomagające usuwanie wydzieliny

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Tlenoterapia i wsparcie oddechowe

W zależności od nasilenia atelektazy i stopnia hipoksemii, mogą być zastosowane następujące interwencje3031:

  • Tlenoterapia – podawanie tlenu w celu utrzymania saturacji powyżej 90%
  • Ciągłe dodatnie ciśnienie w drogach oddechowych (CPAP) – może być skuteczne w poprawie natlenienia i rozprężeniu zapadniętego płuca
  • Przerywaną wentylację dodatnim ciśnieniem (IPPB) – metoda dostarczania dodatniego ciśnienia, które pomaga otworzyć pęcherzyki płucne
  • Odsysanie dróg oddechowych – w przypadku nagromadzenia wydzieliny, której pacjent nie może samodzielnie odkrztusić

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Leczenie farmakologiczne

Interwencje farmakologiczne mogą obejmować3334:

  • Leki rozszerzające oskrzela – w celu otwarcia dróg oddechowych
  • Mukolityków – w celu rozrzedzenia wydzieliny i ułatwienia jej usuwania
  • DNaza (Dornaza alfa) – enzym, który może być podawany w nebulizacji lub bezpośrednio do tchawicy; rozbija cząsteczki DNA w wydzielinach tchawiczo-oskrzelowych i poprawia właściwości przepływu oraz oczyszczanie śluzu
  • Antybiotyki – w przypadku wtórnej infekcji dróg oddechowych
  • Leki przeciwbólowe – odpowiednie leczenie bólu jest niezbędnym elementem wspomagającym, umożliwiającym pacjentom głębokie oddychanie, skuteczne odkrztuszanie i uczestniczenie w zabiegach fizjoterapii oddechowej

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Monitorowanie stanu pacjenta

Regularne monitorowanie stanu pacjenta z atelektazą obejmuje3637:

  • Ocenę częstości i głębokości oddechów co 2 godziny
  • Monitorowanie saturacji tlenu w sposób ciągły
  • Osłuchiwanie płuc w celu oceny szmerów oddechowych
  • Monitorowanie temperatury ciała co 4 godziny
  • Kontrolę liczby białych krwinek
  • Ocenę bólu i jego skuteczności leczenia
  • Monitorowanie oznak i objawów infekcji
  • Obserwację parametrów życiowych podczas aktywności fizycznej

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Bronchoskopia i inne zabiegi

W przypadkach, gdy standardowe metody leczenia są nieskuteczne, mogą być zastosowane bardziej inwazyjne techniki3940:

  • Bronchoskopia – zarówno diagnostyczna, jak i terapeutyczna; pozwala na bezpośrednią inspekcję oskrzeli, usunięcie wydzieliny, korków śluzowych lub ciał obcych. Badanie retrospektywne wykazało, że leczenie atelektazy za pomocą elastycznej bronchoskopii było skuteczne w 74,3% przypadków bez żadnej śmiertelności związanej z procedurą lub zagrażających życiu powikłań.
  • Sztywna bronchoskopia – stosowana w leczeniu atelektazy płuc u dzieci do usuwania korków śluzowych, gęstych wydzielin i usuwania ciał obcych. Jest bezpieczna, ale wymaga znieczulenia ogólnego.
  • Toracenteza – usunięcie płynu przez aspirację igłową lub wprowadzenie drenu do klatki piersiowej w przypadku obecności płynu w opłucnej.

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Edukacja pacjenta i rodziny

Edukacja pacjenta i rodziny jest kluczowym elementem kompleksowej opieki nad pacjentem z atelektazą. Pielęgniarka powinna przekazać informacje dotyczące4344:

  • Technik głębokiego oddychania i efektywnego kaszlu, które pacjent może wykonywać samodzielnie
  • Prawidłowego korzystania ze spirometru zachęcającego
  • Znaczenia wczesnej mobilizacji i regularnej zmiany pozycji ciała
  • Środków zapobiegawczych, które pacjent może podjąć
  • Objawów, które powinny skłonić pacjenta do poszukiwania pomocy medycznej
  • Znaczenia odpowiedniego nawodnienia dla rozrzedzenia wydzieliny
  • Unikania palenia, które może powodować uszkodzenie płuc

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Ważne jest, aby pacjent zrozumiał znaczenie głębokiego oddychania i kaszlu w zapobieganiu powikłaniom, takim jak zapalenie płuc. Edukacja powinna odbywać się przed zabiegiem operacyjnym, jeśli to możliwe, aby pacjent miał czas na przećwiczenie technik46.

Zapobieganie atelektazie

Zapobieganie atelektazie jest kluczowe dla poprawy wyników leczenia pacjentów, szczególnie w okresie pooperacyjnym. Niestety, atelektazy nie zawsze można zapobiec, dlatego wczesne rozpoznanie i leczenie są również ważne, ponieważ mogą skrócić czas hospitalizacji, obniżyć koszty i poprawić wyniki leczenia pacjentów4748.

Strategie zapobiegawcze

Do skutecznych strategii zapobiegania atelektazie należą4950:

  • Wczesna mobilizacja – zachęcanie pacjentów, szczególnie po zabiegach operacyjnych, do jak najszybszego poruszania się
  • Spirometria zachęcająca – nauczanie pacjentów korzystania ze spirometrii zachęcającej, która pomaga im wykonywać głębokie, powolne oddechy, które w pełni rozprężają płuca
  • Odpowiednie nawodnienie – edukowanie pacjentów o konieczności picia odpowiedniej ilości płynów, ponieważ nawodnienie pomaga rozrzedzić wydzielinę dróg oddechowych, ułatwiając jej odkrztuszanie
  • Odpowiednie leczenie bólu – zastosowanie właściwego leczenia przeciwbólowego, które umożliwia pacjentom wykonywanie głębokich oddechów i efektywne odkrztuszanie
  • Fizjoterapia oddechowa – wszyscy pacjenci, którzy przeszli poważny zabieg operacyjny, powinni zostać skierowani na fizjoterapię oddechową jako środek zapobiegawczy
  • Unikanie palenia – edukacja pacjentów na temat szkodliwości palenia i jego wpływu na układ oddechowy

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Należy również zwrócić szczególną uwagę na pacjentów z grupy wysokiego ryzyka, takich jak osoby z chorobami płuc, osoby otyłe, osoby starsze czy osoby poddawane rozległym zabiegom chirurgicznym, wdrażając u nich intensywniejsze działania profilaktyczne52.

Oczekiwane wyniki i ocena skuteczności

Oczekiwane wyniki leczenia atelektazy obejmują5354:

  • Zmniejszenie lęku
  • Normalizację liczby białych krwinek
  • Skuteczne oczyszczanie dróg oddechowych
  • Zwiększenie natlenienia
  • Brak oznak i objawów infekcji
  • Utrzymanie saturacji tlenem powyżej 95% na powietrzu atmosferycznym
  • Czysty obraz RTG klatki piersiowej, bez cech zapalenia płuc

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Ocena skuteczności planu opieki obejmuje monitorowanie zmian w ruchomości klatki piersiowej pacjenta i zdolności do tolerowania aktywności podczas otrzymywania tlenoterapii. Poprawa saturacji tlenem i ustąpienie objawów, takich jak ból i niepokój, wskazują na powodzenie planu opieki56.

W większości przypadków atelektaza jest odwracalna po leczeniu przyczyny. Większość pacjentów szybko dochodzi do zdrowia i nie ma poważnych trwałych skutków. U osób z długotrwałym (przewlekłym) schorzeniem może być konieczne dalsze leczenie w celu opanowania podstawowej przyczyny atelektazy57.

Powikłania atelektazy

Jeśli atelektaza nie jest leczona, może prowadzić do powikłań, w tym5859:

  • Zapalenia płuc – zalegający śluz może spowodować infekcję w płucach
  • Hipoksemii (niskiego poziomu tlenu we krwi) – płuca nie mogą efektywnie dostarczać tlenu do reszty ciała
  • Niewydolności oddechowej – w ciężkich przypadkach
  • Przedłużonej hospitalizacji – zwiększonych kosztów leczenia

W podsumowaniu, odpowiednia opieka pielęgniarska nad pacjentem z atelektazą wymaga kompleksowego podejścia, obejmującego ocenę stanu pacjenta, wdrożenie odpowiednich interwencji, monitorowanie postępów oraz edukację pacjenta i jego rodziny. Zapobieganie atelektazie oraz wczesne rozpoznanie i leczenie są kluczowe dla zmniejszenia ryzyka powikłań i poprawy wyników leczenia60.

Kolejne rozdziały

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  1. 11.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Atelectasis: Definition, Symptoms, Causes | Vaia
    https://www.vaia.com/en-us/explanations/nursing/human-anatomy/atelectasis/
    Atelectasis is a breathing complication that arises when small air sacs in the lungs, also known as alveoli, collapse or fail to inflate properly. This defect in the lung function can lead to decreased oxygen levels in the bloodstream, causing shortness of breath and potential discomfort to the patient. […] Nursing interventions in atelectasis treatment are therapeutic actions taken by a nurse to implement a patient’s care plan. These actions contribute to patient comfort, recovery, and prevent further complications. […] As a nurse, you can play an instrumental role in mitigating the symptoms of atelectasis. Here are some effective nursing interventions: Encourage deep breathing and use of an incentive spirometer, a device that supports keeping the airways open through deep breaths. Position the patient to promote drainage of secretions. Offer frequent patient turnings for immobilized individuals. Early ambulation – a key preventive measure for post-surgery atelectasis.
  • #2 Atelectasis: Causes, Symptoms, Diagnosis & Treatment
    https://my.clevelandclinic.org/health/diseases/17699-atelectasis
    Atelectasis happens when lung sacs (alveoli) cant inflate properly, which means blood, tissues and organs may not get oxygen. It can be caused by pressure outside of your lung, a blockage, low airflow or scarring. The most common cause of atelectasis is surgery with anesthesia. Atelectasis usually resolves after treating the underlying cause. […] Atelectasis can be compressive, resorptive/obstructive, or contraction. Compressive atelectasis is when fluid, air, blood or a tumor presses on alveoli from the outside. Resorptive atelectasis happens when no new air can move into the alveoli (for instance, theres a blockage). Contraction atelectasis is the result of lung scarring. […] If you havent had a chest or abdominal surgery recently, atelectasis can indicate an obstruction of your airway thats causing a partial or complete collapse of your lung.
  • #3 Atelectasis: Definition, types, causes, and treatments
    https://www.medicalnewstoday.com/articles/atelectasis
    Atelectasis is when the airways or air sacs in the lungs collapse or do not fully expand. Symptoms can include shallow breathing, coughing, and wheezing. Treatment may involve medications, breathing exercises, or surgery. […] Around 90% of people who are placed under general anesthetic during surgery experience atelectasis afterward. […] Postoperative atelectasis usually develops within 72 hours of receiving general anesthesia because of altered gas exchange during sedation. […] Common treatments for atelectasis include inhaled medications, breathing and coughing exercises, assistive breathing machines, sitting upright, and getting up and moving around soon after surgery. […] There are several factors that healthcare professionals believe increase the risk of developing atelectasis, especially following surgery.
  • #4 Atelectasis – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/atelectasis/symptoms-causes/syc-20369684
    Atelectasis is one of the most common breathing complications after surgery. […] Treatment depends on what’s causing the collapse and how severe it is. […] Always get medical attention right away if you have a hard time breathing. Other conditions besides atelectasis can make it hard to breathe, so it’s important to get the right diagnosis and treatment. […] If you’re scheduled for surgery, talk with your doctor about ways to lower your risk. Some research shows that certain breathing exercises and muscle training may lower the risk of atelectasis after some surgeries.
  • #5 Atelectasis (Nursing) – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/sites/books/NBK572133/
    Atelectasis is one of three types: compressive, due to lung tissue compression, resorptive, caused by absorption of alveolar air, or related to an impairment of pulmonary surfactant production or function. […] In obstructive atelectasis, the air in the alveoli is absorbed distal to the point of obstruction. This is why it is referred to as resorptive atelectasis. […] Postoperative atelectasis is normally seen within typically 72 hours of surgery using general anesthesia. Atelectasis is a known complication of general anesthesia. […] Patients enter the hospital environment with a variety of risk factors that place them at risk for the development of atelectasis. Among these risk factors is a history of cardiovascular disease, pulmonary disease, particularly chronic obstructive pulmonary disease, neuromuscular disease, kidney failure, cancer, and autoimmune disorders.
  • #6 Atelectasis (Nursing) – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK572133/
    Atelectasis is one of three types: compressive, due to lung tissue compression, resorptive, caused by absorption of alveolar air, or related to an impairment of pulmonary surfactant production or function. […] In obstructive atelectasis, the air in the alveoli is absorbed distal to the point of obstruction. This is why it is referred to as resorptive atelectasis. […] Postoperative atelectasis is normally seen within typically 72 hours of surgery using general anesthesia. Atelectasis is a known complication of general anesthesia. […] Patients enter the hospital environment with a variety of risk factors that place them at risk for the development of atelectasis. […] Incentive spirometry has been a mainstay of nursing postoperative atelectasis prevention. Recent studies have indicated that incentive spirometry alone may not be sufficient to prevent untoward outcomes in postoperative patients.
  • #7 Atelectasis: Causes, Symptoms, Diagnosis & Treatment
    https://my.clevelandclinic.org/health/diseases/17699-atelectasis
    Atelectasis happens when lung sacs (alveoli) cant inflate properly, which means blood, tissues and organs may not get oxygen. It can be caused by pressure outside of your lung, a blockage, low airflow or scarring. The most common cause of atelectasis is surgery with anesthesia. Atelectasis usually resolves after treating the underlying cause. […] Atelectasis can be compressive, resorptive/obstructive, or contraction. Compressive atelectasis is when fluid, air, blood or a tumor presses on alveoli from the outside. Resorptive atelectasis happens when no new air can move into the alveoli (for instance, theres a blockage). Contraction atelectasis is the result of lung scarring. […] If you havent had a chest or abdominal surgery recently, atelectasis can indicate an obstruction of your airway thats causing a partial or complete collapse of your lung.
  • #8 Atelectasis Care Plan for Nursing Students – Straight A Nursing
    https://straightanursingstudent.com/atelectasis-care-plan-for-nursing-students/
    If you do a google search on atelectasis, you’ll find that there’s all types of atelectasis and it can get real confusing real quick. Essentially atelectasis refers to a condition where the alveoli or even whole lobes (or the whole lung) are collapsed. And because you’ll likely be writing an atelectasis care plan at some point, it’s good to know how it affects your patients and how you, the nurse, can prevent it. […] Postoperative atelectasis is likely to be the one you’ll come across the most. This is a pretty common post-op complication, especially in the first few days after surgery. It occurs because general anesthesia changes the patient’s breathing patterns which leads to impaired gas exchange. […] Your atelectasis care plan will most likely be dealing with this type, and when your instructors ask if your patient has atelectasis, this is likely the type they are talking about.
  • #9 Atelectasis: Causes, Symptoms, Diagnosis & Treatment
    https://my.clevelandclinic.org/health/diseases/17699-atelectasis
    Surgery is the most common cause of atelectasis. When anesthesia is used during surgery to keep you asleep, you dont breathe deeply enough to fill your lungs all the way or cough to clear your lungs of mucus. This can lead to blockages or lack of air to the alveoli, causing resorptive atelectasis. […] Many cases of atelectasis get better without treatment, under careful monitoring by your healthcare provider. […] Other treatments depend on the cause and extent of the collapse. Treatments could include: Deep breathing exercises (incentive spirometry). Removing obstructions in your lung (usually using bronchoscopy). Physical therapy to help promote expansion of your lungs. Inhaled medications to open up your airways (bronchodilators). Treatment of tumor or chronic lung conditions. […] Here are some ways to reduce the risk of atelectasis: Get up and walk around, perform breathing exercises and use an incentive spirometer after surgery as directed by your healthcare provider. If you have any underlying conditions that can cause atelectasis, follow your providers recommendations for treating that condition.
  • #10 Atelectasis (Nursing) – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/sites/books/NBK572133/
    Atelectasis is one of three types: compressive, due to lung tissue compression, resorptive, caused by absorption of alveolar air, or related to an impairment of pulmonary surfactant production or function. […] In obstructive atelectasis, the air in the alveoli is absorbed distal to the point of obstruction. This is why it is referred to as resorptive atelectasis. […] Postoperative atelectasis is normally seen within typically 72 hours of surgery using general anesthesia. Atelectasis is a known complication of general anesthesia. […] Patients enter the hospital environment with a variety of risk factors that place them at risk for the development of atelectasis. Among these risk factors is a history of cardiovascular disease, pulmonary disease, particularly chronic obstructive pulmonary disease, neuromuscular disease, kidney failure, cancer, and autoimmune disorders.
  • #11 Atelectasis (Nursing) Article
    https://www.statpearls.com/articlelibrary/nursingarticle/17940
    Atelectasis is one of three types: compressive, due to lung tissue compression, resorptive, caused by absorption of alveolar air, or related to an impairment of pulmonary surfactant production or function. […] Atelectasis is more common in those who have recently had surgery using general anesthesia. Incidence has been reported as high as 90% in this group. […] Patients enter the hospital environment with a variety of risk factors that place them at risk for the development of atelectasis. Among these risk factors is a history of cardiovascular disease, pulmonary disease, particularly chronic obstructive pulmonary disease, neuromuscular disease, kidney failure, cancer, and autoimmune disorders. […] Incentive spirometry has been a mainstay of nursing postoperative atelectasis prevention. Recent studies have indicated that incentive spirometry alone may not be sufficient to prevent untoward outcomes in postoperative patients. Evidence indicates that the use of deep breathing, adequate pain relief, directed cough, and early patient mobilization are also necessary to increase lung volumes. […] Preventing atelectasis is vital to improving the outcomes of the postoperative patient. Unfortunately, atelectasis may not always be prevented. Therefore, early recognition and treatment are also important, as this can decrease the length of hospitalization, cost, and improve patient outcomes.
  • #12 Atelectasis Care Plan for Nursing Students – Straight A Nursing
    https://straightanursingstudent.com/atelectasis-care-plan-for-nursing-students/
    When atelectasis occurs, it’s not just a few alveoli…it’s typically whole lobes or areas of the lung. […] If the alveolar membrane is collapsed or compromised in some way, we have issues with gas exchange. […] The good news is, it is often very treatable and very easy to treat at that! […] Patients with atelectasis may have no symptoms at all, but when they do show symptoms they can range from mild to severe. […] When we’re talking about post-op atelectasis or atelectasis from someone not taking deep breaths or getting out of bed and moving around as they should, the remedy is usually pretty simple. […] If you assess your patient and you notice they are taking shallow breaths, even with or without a lower-than-expected O2 saturation, you want to have them cough and take some deep breaths.
  • #13 Nursing care plan for atelectasis
    https://nursipedia.com/nursing-care-plan-atelectasis/
    Atelectasis is defined as the collapsed state of a lung or parts of a lung due to the engulfment of air resulting in impaired gas exchange. It is a frequent complication of severe illnesses or pulmonary operations and is a major cause of morbidity and mortality in patients. Nursing care plan for atelectasis includes assessment, diagnosis, outcomes, interventions, rationales, evaluation, and conclusion. […] Assessment involves determining the factors contributing to atelectasis and the patients current physical and mental status including their vital signs, breath sounds, heart rate, and respiratory rate. The patient should be monitored for signs of respiratory distress such as use of accessory muscles and restlessness or agitation. Pursed lip breathing and other breathing techniques can also be observed. Pulse oximetry will assess oxygen saturation levels. Radiographic imaging such as X-rays or CT scans can be performed to identify the extent of the disease.
  • #14 Impaired Gas Exchange Nursing Diagnosis & Care Plan – Nurseslabs
    https://nurseslabs.com/impaired-gas-exchange/
    Monitor for signs and symptoms of atelectasis: bronchial or tubular breath sounds, crackles, diminished chest excursion, limited diaphragm excursion, and tracheal shift to the affected side. […] Conditions that cause changes or collapse of the alveoli (e.g., atelectasis, pneumonia, pulmonary edema, and acute respiratory distress syndrome) impair ventilation. […] Decreased lung expansion (e.g., atelectasis) […] Impaired Gas Exchange related to decreased lung expansion due to restrictive lung disease, leading to insufficient oxygenation of blood as evidenced by decreased breath sounds, use of accessory muscles to breathe, and abnormal chest X-ray findings. […] Impaired Gas Exchange related to airway obstruction (e.g., asthma or bronchiolitis), as evidenced by wheezing on auscultation, increased peak expiratory flow rate variability, and difficulty speaking in full sentences.
  • #15 Nursing Care Plan For Atelectasis – Made For Medical
    https://www.madeformedical.com/nursing-care-plan-for-atelectasis/
    Atelectasis is a condition characterized by the partial or complete collapse of the lung or a portion of it. It occurs due to the loss of lung volume, leading to impaired gas exchange and respiratory function. Developing a comprehensive nursing care plan for atelectasis is essential to effectively manage the condition, prevent complications, and promote optimal lung expansion and ventilation. […] The nursing care plan for atelectasis focuses on addressing the unique needs of individuals with this condition and aims to optimize respiratory function, prevent further lung collapse, and enhance overall pulmonary health. It involves a holistic approach that encompasses assessment, diagnosis, planning, implementation, and evaluation. […] Key components of the nursing care plan for atelectasis include monitoring respiratory status, promoting effective airway clearance, optimizing lung expansion, providing education and support, and collaborating with the healthcare team to ensure coordinated and integrated care.
  • #16 Atelectasis: Nursing Diagnosis & Interventions | Nurse.com
    https://www.nurse.com/clinical-guides/atelectasis/?srsltid=AfmBOoqCkLYseFur4-2UUp2TQU3bkx897lZ0xzV2Dhg6cDLwMePy12nU
    Atelectasis Nursing Care Plan […] Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnosis, interventions, expected outcomes, and education for individuals with atelectasis are listed below. […] Nursing Diagnosis/Risk For […] Activity intolerance […] Anxiety […] Impaired gas exchange […] Ineffective airway clearance […] Ineffective breathing pattern […] Infection […] Pain […] Interventions […] Ambulation […] Assess respiratory rates and depth […] Cough and deep breath exercises […] Incentive spirometer […] Monitor the following: […] Lung sounds […] Temperature […] White blood cells […] Pain management […] Expected Outcomes […] Decreased anxiety […] Decreased white blood cells
  • #17 Atelectasis – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/atelectasis/diagnosis-treatment/drc-20369688
    A doctor’s examination and plain chest X-ray may be all that’s needed to diagnose atelectasis. But other tests may be done to confirm the source of symptoms or figure out the type or severity of atelectasis. […] Treatment of atelectasis depends on the cause. Mild atelectasis may go away without treatment. Sometimes, medicines are used to loosen and thin mucus. If the condition is due to a blockage, you may need surgery or other treatments. […] Chest physical therapy, also called chest physiotherapy, is a group of airway clearance techniques. They help you breathe deeply after surgery to expand collapsed lung tissue. It’s best to learn these techniques before surgery. […] Suctioning mucus or doing a bronchoscopy can get rid of airway blockages. During bronchoscopy, the doctor gently guides a flexible tube down your throat to clear your airways. […] In some cases, a breathing tube may be needed. Continuous positive airway pressure (CPAP) may help some people who are too weak to cough and have low oxygen levels, also called hypoxemia, after surgery.
  • #18 Atelectasis: Nursing Diagnosis & Interventions | Nurse.com
    https://www.nurse.com/clinical-guides/atelectasis/?srsltid=AfmBOoqCkLYseFur4-2UUp2TQU3bkx897lZ0xzV2Dhg6cDLwMePy12nU
    Atelectasis Nursing Care Plan […] Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnosis, interventions, expected outcomes, and education for individuals with atelectasis are listed below. […] Nursing Diagnosis/Risk For […] Activity intolerance […] Anxiety […] Impaired gas exchange […] Ineffective airway clearance […] Ineffective breathing pattern […] Infection […] Pain […] Interventions […] Ambulation […] Assess respiratory rates and depth […] Cough and deep breath exercises […] Incentive spirometer […] Monitor the following: […] Lung sounds […] Temperature […] White blood cells […] Pain management […] Expected Outcomes […] Decreased anxiety […] Decreased white blood cells
  • #19 Nursing care plan for atelectasis
    https://nursipedia.com/nursing-care-plan-atelectasis/
    Nursing diagnosis may include Impaired gas exchange, Activity intolerance, Ineffective breathing pattern, Risk for infection, Pain, Diaphoresis, Restlessness, Decreased cardiac output, Anxiety and Risk for impaired tissue integrity. […] The patient will be able to demonstrate improved gas exchange (oxygen saturation and/or ventilation) with no adverse effects; improved activity tolerance; effective breathing patterns; and reduced risk of infection. […] Interventions involve application of skills and strategies to improve oxygenation, expand alveolar surface area, mitigate the effects of affected tissue, and assist the patient in making lifestyle changes. Oxygen therapy, chest physiotherapy, incentive spirometry, use of air nebulizers, assisted cough, proper positioning, and ambulation may be used to improve alveolar expansion. To reduce the risk of infection, proper hygiene, adequate nutrition, and monitoring of vital signs are essential.
  • #20 Atelectasis & nursing care | PPT
    https://www.slideshare.net/slideshow/atelectasis-nursing-care/238530104
    TRATMENT OF ATELECTASIS (Along with above preventive points) Oxygen administration via continuous or intermittent positive pressure-breathing (IPPB). Antibiotic therapy. Thoracentesis, removal of the fluid by needle aspiration, or insertion of a chest tube. Bronchoscopy: To open an airway obstructed by lung cancer or a nonmalignant lesion. […] NURSING MANAGEMENT: Assess the respiratory status Monitor Spo2, Pao2, Paco2 Administer oxygen if required. Administer medication as ordered. Check need for invasive oxygen therapy. Educate patient to cough deep breathing exercises. Steam inhalation. Perform chest physiotherapy Incentive spirometry. […] NURSING DIAGNOSIS Ineffective airway clearance related to excess mucus secretion. Ineffective breathing pattern related to obstruction Ineffective tissue perfusion Activity intolerance Knowledge deficit.
  • #21 Atelectasis: Definition, Symptoms, Causes | Vaia
    https://www.vaia.com/en-us/explanations/nursing/human-anatomy/atelectasis/
    Atelectasis is a breathing complication that arises when small air sacs in the lungs, also known as alveoli, collapse or fail to inflate properly. This defect in the lung function can lead to decreased oxygen levels in the bloodstream, causing shortness of breath and potential discomfort to the patient. […] Nursing interventions in atelectasis treatment are therapeutic actions taken by a nurse to implement a patient’s care plan. These actions contribute to patient comfort, recovery, and prevent further complications. […] As a nurse, you can play an instrumental role in mitigating the symptoms of atelectasis. Here are some effective nursing interventions: Encourage deep breathing and use of an incentive spirometer, a device that supports keeping the airways open through deep breaths. Position the patient to promote drainage of secretions. Offer frequent patient turnings for immobilized individuals. Early ambulation – a key preventive measure for post-surgery atelectasis.
  • #22 Atelectasis (Nursing) – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK572133/
    Preventing atelectasis is vital to improving the outcomes of the postoperative patient. Unfortunately, atelectasis may not always be prevented. Therefore, early recognition and treatment are also important, as this can decrease the length of hospitalization, cost, and improve patient outcomes. […] Treatment addresses underlying causes of the condition but consists most often of supportive measures, such as deep breathing, incentive spirometry, and providing supplemental O2.
  • #23 Atelectasis (Aftercare Instructions)
    https://www.drugs.com/cg/atelectasis-aftercare-instructions.html
    Atelectasis is a condition that happens when the alveoli in your lungs cannot expand fully. This may cause part or all of your lung to collapse. […] Manage or prevent atelectasis: Change your position often. Sit on the side of the bed or walk after surgery as directed. This helps expand your lungs. Your healthcare provider may ask you to lie or sit in certain positions to help drain mucus. This is called postural drainage. […] Use chest percussion. Chest percussion is gentle clapping on your back or side to help move mucus out of your lungs. Chest percussion is sometimes used with postural drainage. Ask your provider for more information about postural drainage and chest percussion. […] Cough often. This can help clear mucus from your lungs. […] Do deep breathing exercises. This can help improve your lung function and decrease your risk for atelectasis. An incentive spirometer may be used to help you breathe deeply and slowly. […] Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung damage. […] Drink liquids as directed. Liquids help loosen mucus. Ask how much liquid to drink each day and which liquids are best for you.
  • #24 Nursing Care Plan For Atelectasis – Made For Medical
    https://www.madeformedical.com/nursing-care-plan-for-atelectasis/
    Through regular assessment, nursing professionals can monitor the patients respiratory rate, oxygen saturation levels, breath sounds, and signs of respiratory distress. This information guides the development of individualized care plans and helps in early intervention. Airway clearance is a critical aspect of the care plan for atelectasis. Nurses may implement strategies such as deep breathing exercises, incentive spirometry, coughing techniques, and suctioning to promote effective removal of secretions and maintain airway patency. […] Promoting lung expansion is another key intervention. Nurses may encourage the patient to engage in activities that facilitate deep breathing and lung inflation, such as ambulation, positioning, and the use of positive pressure devices like continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP).
  • #25 Post-Operative Atelectasis – Risk Factors – Management – TeachMeSurgery
    https://teachmesurgery.com/perioperative/cardiorespiratory/atelectasis/
    Atelectasis refers to a partial collapse of the small airways. The majority of post-operative patients will develop some degree of atelectasis, resulting in abnormal alterations in lung function or compromise to the lungs immune defences. […] It is a clinically important condition as it is often a precursor or contributor to other important, and often more severe, post-operative pulmonary complications. […] The most effective treatments for atelectasis are deep breathing exercises and chest physiotherapy. This ensures that the airways are opened maximally and coughing can be performed effectively. As an adjunct, ensure that the patient has adequate pain control to allow them to deep breathe. […] All patients who have undergone major surgery should be referred to receive chest physiotherapy as a preventative measure. This has been shown to significantly reduce the risk of developing atelectasis. Patients should undertake regular deep breathing exercises or use devices such as an incentive spirometer. […] Pain control and physiotherapy form the mainstay of management.
  • #26 Treatment of atelectasis: where is the evidence? | Critical Care | Full Text
    https://ccforum.biomedcentral.com/articles/10.1186/cc3766
    Lobar atelectasis is a common problem caused by a variety of mechanisms including resorption atelectasis due to airway obstruction, passive atelectasis from hypoventilation, compressive atelectsis from abdominal distension and adhesive atelectasis due to increased surface tension. […] Chest physiotherapy, nebulised DNase and possibly fibreoptic bronchoscopy might be helpful in patients with mucous plugging of the airways. […] In passive and adhesive atelectasis, positive end-expiratory pressure might be a useful adjunct to treatment. […] Chest physiotherapy is the traditional first-line therapy for atelectasis; however, even for this basic therapy, evidence is lacking: there are only two published studies. […] Fibreoptic bronchoscopy to aspirate secretions has been used in the management of proximal airway obstruction, and has been found to resolve atelectasis successfully in 26 of 35 (74%) paediatric intensive care patients.
  • #27 Atelectasis (Aftercare Instructions)
    https://www.drugs.com/cg/atelectasis-aftercare-instructions.html
    Atelectasis is a condition that happens when the alveoli in your lungs cannot expand fully. This may cause part or all of your lung to collapse. […] Manage or prevent atelectasis: Change your position often. Sit on the side of the bed or walk after surgery as directed. This helps expand your lungs. Your healthcare provider may ask you to lie or sit in certain positions to help drain mucus. This is called postural drainage. […] Use chest percussion. Chest percussion is gentle clapping on your back or side to help move mucus out of your lungs. Chest percussion is sometimes used with postural drainage. Ask your provider for more information about postural drainage and chest percussion. […] Cough often. This can help clear mucus from your lungs. […] Do deep breathing exercises. This can help improve your lung function and decrease your risk for atelectasis. An incentive spirometer may be used to help you breathe deeply and slowly. […] Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung damage. […] Drink liquids as directed. Liquids help loosen mucus. Ask how much liquid to drink each day and which liquids are best for you.
  • #28 Atelectasis & nursing care | PPT
    https://www.slideshare.net/slideshow/atelectasis-nursing-care/238530104
    TRATMENT OF ATELECTASIS (Along with above preventive points) Oxygen administration via continuous or intermittent positive pressure-breathing (IPPB). Antibiotic therapy. Thoracentesis, removal of the fluid by needle aspiration, or insertion of a chest tube. Bronchoscopy: To open an airway obstructed by lung cancer or a nonmalignant lesion. […] NURSING MANAGEMENT: Assess the respiratory status Monitor Spo2, Pao2, Paco2 Administer oxygen if required. Administer medication as ordered. Check need for invasive oxygen therapy. Educate patient to cough deep breathing exercises. Steam inhalation. Perform chest physiotherapy Incentive spirometry. […] NURSING DIAGNOSIS Ineffective airway clearance related to excess mucus secretion. Ineffective breathing pattern related to obstruction Ineffective tissue perfusion Activity intolerance Knowledge deficit.
  • #29 Atelectasis – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/atelectasis/diagnosis-treatment/drc-20369688
    A doctor’s examination and plain chest X-ray may be all that’s needed to diagnose atelectasis. But other tests may be done to confirm the source of symptoms or figure out the type or severity of atelectasis. […] Treatment of atelectasis depends on the cause. Mild atelectasis may go away without treatment. Sometimes, medicines are used to loosen and thin mucus. If the condition is due to a blockage, you may need surgery or other treatments. […] Chest physical therapy, also called chest physiotherapy, is a group of airway clearance techniques. They help you breathe deeply after surgery to expand collapsed lung tissue. It’s best to learn these techniques before surgery. […] Suctioning mucus or doing a bronchoscopy can get rid of airway blockages. During bronchoscopy, the doctor gently guides a flexible tube down your throat to clear your airways. […] In some cases, a breathing tube may be needed. Continuous positive airway pressure (CPAP) may help some people who are too weak to cough and have low oxygen levels, also called hypoxemia, after surgery.
  • #30 Atelectasis Treatment & Management: Medical Care, Surgical Care
    https://emedicine.medscape.com/article/296468-treatment
    When these efforts are not successful within 24 hours, flexible fiberoptic bronchoscopy could be performed. […] Prevention of further atelectasis involves (1) placing the patient in such a position that the uninvolved side is dependent to promote increased drainage of the affected area, (2) giving vigorous chest physiotherapy, and (3) encouraging the patient to cough and to breathe deeply. […] Patients may require nasotracheal suctioning if atelectasis recurs. […] Therapy with a broad-spectrum antibiotic is started and modified appropriately if a specific pathogen is isolated from sputum samples or bronchial secretions. […] Postoperative atelectasis is treated with adequate oxygenation and re-expansion of the lung segments. […] Severe hypoxemia associated with severe respiratory distress should lead to intubation and mechanical support.
  • #31 Atelectasis Treatment & Management: Medical Care, Surgical Care
    https://emedicine.medscape.com/article/296468-treatment
    Continuous positive airway pressure delivered via a nasal cannula or facemask may also be effective in improving oxygenation and re-expanding the collapsed lung. […] Broad-spectrum antibiotics should be prescribed if evidence of infection is present, such as fever, night sweats, or leukocytosis, because secondary atelectasis usually becomes infected regardless of the cause of obstruction. […] Judicious use of perioperative analgesia is an essential adjunct, permitting patients to breathe deeply, cough forcefully, and participate in chest physiotherapy maneuvers. […] Prophylactic maneuvers for reducing the incidence and magnitude of postoperative atelectasis in high-risk patients should be encouraged. […] Kato et al reported on the use of the RTX respirator for extensive atelectasis in elderly patients.
  • #32 Pulmonary Atelectasis Treatment & Management: Medical Care, Surgical Care, Prevention
    https://emedicine.medscape.com/article/1001160-treatment
    A randomized controlled trial by Roncin et al showed that continuous positive airway pressure delivered via a nasal cannula or facemask is effective in improving oxygenation and re-expanding the collapsed lung. […] If the child with atelectasis has cystic fibrosis, aggressive antibiotic therapy is indicated in conjunction with chest physical therapy and postural drainage. A mucus plug from other causes may respond to chest physical therapy and postural drainage. […] Children with neuromuscular disease, children who have undergone surgery, and children with chest pain benefit from chest physical therapy to reduce the likelihood of developing further atelectasis; whether these procedures treat the existing atelectasis is not clear. In children with neuromuscular disease, the mechanical ex-insufflator (Cough Assist Device) is helpful in preventing atelectasis and produces enough of a cough to adequately clear the airways. […] If pain is causing the atelectasis, adequate pain therapy is mandatory.
  • #33 Atelectasis Treatment & Management: Medical Care, Surgical Care
    https://emedicine.medscape.com/article/296468-treatment
    Fiberoptic bronchoscopy should be reserved for those situations in which chest physiotherapy is contraindicated (eg, chest trauma, immobilized patient), poorly tolerated, or unsuccessful. […] Nonpharmacologic therapies for improving cough and clearance of secretions from the airways include chest physiotherapy, including postural drainage, chest wall percussion and vibration, and a forced expiration technique (called huffing). […] The treatment of atelectasis depends on the underlying etiology. […] For postoperative atelectasis, prevention is the best approach. […] Early ambulation and use of incentive spirometry are important. […] Encourage the patient to cough and to breathe deeply. […] In the case of lobar atelectasis, vigorous chest physiotherapy frequently helps re-expand the collapsed lung.
  • #34 Pulmonary Atelectasis Treatment & Management: Medical Care, Surgical Care, Prevention
    https://emedicine.medscape.com/article/1001160-treatment
    Medications including inhaled bronchodilators, DNase, and surfactant (see Medications section). […] Dornase alfa (DNase) is a mucolytic therapy and can be administered as nebulized or direct tracheal application. DNase fragments extracellular DNA molecules in tracheobronchial secretions and improves flow properties and clearance of mucus. DNase has been successfully used in patients with cystic fibrosis and others with acute atelectasis. In a retrospective case series involving 25 non-cystic fibrosis children with infectious atelectasis, the administration of DNase showed clinical and radiologic improvement. However, the success of the medication depends on the amount of DNA in the secretions, and neutrophil counts in the affected area. […] If the patient is severely affected by the atelectasis and response to therapy of the underlying disorder is suboptimal, bronchoscopic removal of secretions, mucous plugs, or both may be helpful.
  • #35 Atelectasis Treatment & Management: Medical Care, Surgical Care
    https://emedicine.medscape.com/article/296468-treatment
    When these efforts are not successful within 24 hours, flexible fiberoptic bronchoscopy could be performed. […] Prevention of further atelectasis involves (1) placing the patient in such a position that the uninvolved side is dependent to promote increased drainage of the affected area, (2) giving vigorous chest physiotherapy, and (3) encouraging the patient to cough and to breathe deeply. […] Patients may require nasotracheal suctioning if atelectasis recurs. […] Therapy with a broad-spectrum antibiotic is started and modified appropriately if a specific pathogen is isolated from sputum samples or bronchial secretions. […] Postoperative atelectasis is treated with adequate oxygenation and re-expansion of the lung segments. […] Severe hypoxemia associated with severe respiratory distress should lead to intubation and mechanical support.
  • #36 Atelectasis: Nursing Diagnosis & Interventions | Nurse.com
    https://www.nurse.com/clinical-guides/atelectasis/?srsltid=AfmBOoqCkLYseFur4-2UUp2TQU3bkx897lZ0xzV2Dhg6cDLwMePy12nU
    Atelectasis Nursing Care Plan […] Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnosis, interventions, expected outcomes, and education for individuals with atelectasis are listed below. […] Nursing Diagnosis/Risk For […] Activity intolerance […] Anxiety […] Impaired gas exchange […] Ineffective airway clearance […] Ineffective breathing pattern […] Infection […] Pain […] Interventions […] Ambulation […] Assess respiratory rates and depth […] Cough and deep breath exercises […] Incentive spirometer […] Monitor the following: […] Lung sounds […] Temperature […] White blood cells […] Pain management […] Expected Outcomes […] Decreased anxiety […] Decreased white blood cells
  • #37 Atelectasis Nursing Diagnosis & Care Plan – NurseStudy.Net
    https://nursestudy.net/atelectasis-nursing-diagnosis/
    Assess respiratory rate, depth, and pattern q2hRationale: Enables early detection of respiratory deterioration. […] Position patient in semi-Fowlers or upright positionRationale: Promotes optimal lung expansion. […] Implement deep breathing exercises q2h while awakeRationale: Prevents alveolar collapse and promotes gas exchange. […] Monitor oxygen saturation continuouslyRationale: Enables prompt intervention for desaturation. […] Assist with incentive spirometry q1h while awakeRationale: Promotes alveolar recruitment. […] Suction airways as neededRationale: Maintains airway patency. […] Implement progressive mobility protocolRationale: Prevents further deconditioning. […] Monitor vital signs during activityRationale: Ensures safe activity progression. […] Schedule activities with rest periodsRationale: Prevents exhaustion.
  • #38 Impaired Gas Exchange Nursing Diagnosis & Care Plans | NurseTogether
    https://www.nursetogether.com/impaired-gas-exchange-nursing-diagnosis-care-plan/
    Impaired gas exchange related to alveolar-capillary membrane changes secondary to COPD as evidenced by oxygen saturation 79%, heart rate 112 bpm, and patient reports of dyspnea. […] Assess for lung sounds for indications of atelectasis. The collapse of the alveoli can cause hypoxemia. […] Teach the patient how to use breathing and coughing exercises for therapeutic purposes. Using the proper breathing and coughing methods helps promote oxygenation and air exchange while mobilizing secretions, particularly if the patient has atelectasis. […] Note the presence of hypoxia. Assess respirations for rate and quality, as well as the use of accessory muscles. Increased breathing effort is a sign of hypoxia. Changes in breathing patterns can indicate changes in oxygenation status. […] Frequent repositioning promotes drainage and movement of lung secretions. It promotes comfort and lessens breathing effort.
  • #39 Atelectasis Treatment & Management: Medical Care, Surgical Care
    https://emedicine.medscape.com/article/296468-treatment
    Fiberoptic bronchoscopy should be reserved for those situations in which chest physiotherapy is contraindicated (eg, chest trauma, immobilized patient), poorly tolerated, or unsuccessful. […] Nonpharmacologic therapies for improving cough and clearance of secretions from the airways include chest physiotherapy, including postural drainage, chest wall percussion and vibration, and a forced expiration technique (called huffing). […] The treatment of atelectasis depends on the underlying etiology. […] For postoperative atelectasis, prevention is the best approach. […] Early ambulation and use of incentive spirometry are important. […] Encourage the patient to cough and to breathe deeply. […] In the case of lobar atelectasis, vigorous chest physiotherapy frequently helps re-expand the collapsed lung.
  • #40 Treatment of atelectasis: where is the evidence? | Critical Care | Full Text
    https://ccforum.biomedcentral.com/articles/10.1186/cc3766
    Lobar atelectasis is a common problem caused by a variety of mechanisms including resorption atelectasis due to airway obstruction, passive atelectasis from hypoventilation, compressive atelectsis from abdominal distension and adhesive atelectasis due to increased surface tension. […] Chest physiotherapy, nebulised DNase and possibly fibreoptic bronchoscopy might be helpful in patients with mucous plugging of the airways. […] In passive and adhesive atelectasis, positive end-expiratory pressure might be a useful adjunct to treatment. […] Chest physiotherapy is the traditional first-line therapy for atelectasis; however, even for this basic therapy, evidence is lacking: there are only two published studies. […] Fibreoptic bronchoscopy to aspirate secretions has been used in the management of proximal airway obstruction, and has been found to resolve atelectasis successfully in 26 of 35 (74%) paediatric intensive care patients.
  • #41 Pulmonary Atelectasis Treatment & Management: Medical Care, Surgical Care, Prevention
    https://emedicine.medscape.com/article/1001160-treatment
    A pediatric pulmonologist may help diagnose and treat the underlying disorder and may also be helpful if bronchoscopy is necessary. […] Bronchoscopy has both a diagnostic and therapeutic value. Flexible bronchoscopy may help distinguish intrinsic obstruction from extrinsic compression. Direct bronchoscopic inspection can also better define the nature of any intrinsic obstructing lesion. A retrospective study by Bar-Zohar et al in one hundred consecutive infants and children hospitalized in a PICU showed that treatment of atelectasis by flexible fiber optic bronchoscopy was successful in 26 of 35 cases (74.3%) without any procedure-related mortality or life-threatening complications. […] Repeat bronchoscopic examination can be performed for removal of secretions reexpansion of atelectatic segment.
  • #42 Pulmonary Atelectasis Treatment & Management: Medical Care, Surgical Care, Prevention
    https://emedicine.medscape.com/article/1001160-treatment
    Rigid bronchoscopy has been used for treatment of pediatric pulmonary atelectasis for removal of mucus plugs, thick secretions and removal of a foreign body. Rigid bronchoscope is safe but requires general anesthesia. […] Bronchoscopy should be used with caution in patients in a pediatric intensive care unit, who may not be able to tolerate the changes in partial pressure of oxygen and partial pressure of carbon dioxide in arterial blood that often accompany the procedure. Caution is also warranted in patients with traumatic brain injury because of the increase in intracranial pressure that can be associated with bronchoscopy, despite the use of adequate sedation. […] Bronchoscopic surfactant administration was found to be successful in opening the areas of atelectasis and helping wean children from mechanical ventilation.
  • #43 Atelectasis: Nursing Diagnosis & Interventions | Nurse.com
    https://www.nurse.com/clinical-guides/atelectasis/?srsltid=AfmBOoqCkLYseFur4-2UUp2TQU3bkx897lZ0xzV2Dhg6cDLwMePy12nU
    Effective airway clearance […] Increased oxygenation […] No signs and symptoms of infection […] Individual/Caregiver Education […] Teach coughing exercises and deep breathing techniques the individual can do on their own. […] Demonstrate how to use an incentive spirometer. […] Outline prevention measures the individual can take. […] Identify signs and symptoms to indicate when the individual should seek medical attention.
  • #44 Atelectasis: Definition, Symptoms, Causes | Vaia
    https://www.vaia.com/en-us/explanations/nursing/human-anatomy/atelectasis/
    Preventing atelectasis, especially following surgery or in immobilized patients, can greatly improve patient outcomes and reduce healthcare burdens. By promoting lung fitness, you can help prevent the occurrence of collapsed alveoli. […] To prevent atelectasis, comprehensive knowledge of risk factors and preventative measures is paramount. Here are some nursing recommendations: Early mobilisation: Encourage patients, especially post-surgical ones, to get moving as soon as possible. Incentive Spirometry: By teaching patients to use incentive spirometry, you can help them to take deep, slow breaths that fully inflate their lungs. Proper Hydration: Educate patients about the necessity of drinking adequate amounts of fluids, as hydration helps to thin respiratory secretions, making them easier to cough up. […] Patient education is crucial in preventing atelectasis as it ensures patients understand why and how to perform deep-breathing exercises, incentives spirometry, and postural drainage. Awareness also promotes early detection of symptoms, improving outcomes and reducing hospital stays.
  • #45 Nursing Care Plan For Atelectasis – Made For Medical
    https://www.madeformedical.com/nursing-care-plan-for-atelectasis/
    Education and support are essential components of the nursing care plan for atelectasis. Nurses provide information on the causes and risk factors of atelectasis, techniques for airway clearance, the importance of maintaining good respiratory hygiene, and strategies for preventing further lung collapse. They also address patient and family concerns, provide emotional support, and help individuals cope with the impact of atelectasis on their daily lives. […] A comprehensive nursing assessment provides a foundation for developing an individualized care plan for individuals with atelectasis. It guides the selection of appropriate nursing interventions, facilitates effective secretion management, and promotes respiratory health. Regular reassessment is essential to monitor disease progression, identify emerging needs, and adapt the care plan accordingly. Collaboration with the healthcare team, including physicians, respiratory therapists, and other specialists, ensures a holistic and coordinated approach to care.
  • #46
    https://care24.co.in/nursing/atelectasis/
    Nursing care plan for atelectasis is most essential so that patient could practice the time to educate an incentive is preoperative. Describe that breathing exercises avoid issues like pneumonia and can help the patient maintain lungs inflated. For hints on visual reinforcement, visit picturing a balloon. […] Evidence for the effectiveness of remedies for atelectasis is absent or weak. However, commonly recommended steps comprise chest physiotherapy to help maintain equilibrium and clearance of secretions, and reinforcement of lung growth techniques like guided cough, deep breathing exercises, and utilization of an incentive spirometer. […] Nursing care services for ATELECTASIS. […] Nursing care plan for atelectasis is most essential so that patient could practice the time to educate an incentive is preoperative. Describe that breathing exercises avoid issues like pneumonia and can help the patient maintain lungs inflated. For hints on visual reinforcement, visit picturing a balloon.
  • #47 Atelectasis (Nursing) – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK572133/
    Preventing atelectasis is vital to improving the outcomes of the postoperative patient. Unfortunately, atelectasis may not always be prevented. Therefore, early recognition and treatment are also important, as this can decrease the length of hospitalization, cost, and improve patient outcomes. […] Treatment addresses underlying causes of the condition but consists most often of supportive measures, such as deep breathing, incentive spirometry, and providing supplemental O2.
  • #48 Atelectasis (Nursing) – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/sites/books/NBK572133/
    Incentive spirometry has been a mainstay of nursing postoperative atelectasis prevention. Recent studies have indicated that incentive spirometry alone may not be sufficient to prevent untoward outcomes in postoperative patients. Evidence indicates that the use of deep breathing, adequate pain relief, directed cough, and early patient mobilization are also necessary to increase lung volumes. […] Preventing atelectasis is vital to improving the outcomes of the postoperative patient. Unfortunately, atelectasis may not always be prevented. Therefore, early recognition and treatment are also important, as this can decrease the length of hospitalization, cost, and improve patient outcomes.
  • #49 Atelectasis: Causes, Symptoms, Diagnosis & Treatment
    https://my.clevelandclinic.org/health/diseases/17699-atelectasis
    Surgery is the most common cause of atelectasis. When anesthesia is used during surgery to keep you asleep, you dont breathe deeply enough to fill your lungs all the way or cough to clear your lungs of mucus. This can lead to blockages or lack of air to the alveoli, causing resorptive atelectasis. […] Many cases of atelectasis get better without treatment, under careful monitoring by your healthcare provider. […] Other treatments depend on the cause and extent of the collapse. Treatments could include: Deep breathing exercises (incentive spirometry). Removing obstructions in your lung (usually using bronchoscopy). Physical therapy to help promote expansion of your lungs. Inhaled medications to open up your airways (bronchodilators). Treatment of tumor or chronic lung conditions. […] Here are some ways to reduce the risk of atelectasis: Get up and walk around, perform breathing exercises and use an incentive spirometer after surgery as directed by your healthcare provider. If you have any underlying conditions that can cause atelectasis, follow your providers recommendations for treating that condition.
  • #50 Atelectasis: Definition, types, causes, and treatments
    https://www.medicalnewstoday.com/articles/atelectasis
    Some methods may also help prevent the risk of developing atelectasis, especially before surgery or medical procedures involving sedation. […] Atelectasis usually resolves itself with time or treatment, while lung or airway collapse is reversible. […] However, if atelectasis is left undiagnosed or untreated, serious complications can develop. These can be potentially fatal, including but not limited to respiratory infections such as pneumonia and respiratory failure. […] Most people recover from atelectasis with proper treatment within 24 hours. However, without medical intervention, atelectasis can lead to serious complications, including death.
  • #51 Post-Operative Atelectasis – Risk Factors – Management – TeachMeSurgery
    https://teachmesurgery.com/perioperative/cardiorespiratory/atelectasis/
    Atelectasis refers to a partial collapse of the small airways. The majority of post-operative patients will develop some degree of atelectasis, resulting in abnormal alterations in lung function or compromise to the lungs immune defences. […] It is a clinically important condition as it is often a precursor or contributor to other important, and often more severe, post-operative pulmonary complications. […] The most effective treatments for atelectasis are deep breathing exercises and chest physiotherapy. This ensures that the airways are opened maximally and coughing can be performed effectively. As an adjunct, ensure that the patient has adequate pain control to allow them to deep breathe. […] All patients who have undergone major surgery should be referred to receive chest physiotherapy as a preventative measure. This has been shown to significantly reduce the risk of developing atelectasis. Patients should undertake regular deep breathing exercises or use devices such as an incentive spirometer. […] Pain control and physiotherapy form the mainstay of management.
  • #52 Atelectasis – Lung and Airway Disorders – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/lung-and-airway-disorders/bronchiectasis-and-atelectasis/atelectasis
    Atelectasis is a condition in which all or part of a lung becomes airless and collapses. […] Blockage of the bronchial tubes is a common cause of atelectasis. […] Treatment may involve making sure deep breathing occurs, relieving airway blockages, or both. […] Treatment of atelectasis may involve making sure deep breathing occurs, relieving airway blockages, or both. […] Atelectasis may be prevented by making sure deep breathing occurs. […] All people who have surgery should be encouraged to breathe deeply, cough regularly, and move about as soon as possible after the operation.
  • #53 Atelectasis: Nursing Diagnosis & Interventions | Nurse.com
    https://www.nurse.com/clinical-guides/atelectasis/?srsltid=AfmBOoqCkLYseFur4-2UUp2TQU3bkx897lZ0xzV2Dhg6cDLwMePy12nU
    Effective airway clearance […] Increased oxygenation […] No signs and symptoms of infection […] Individual/Caregiver Education […] Teach coughing exercises and deep breathing techniques the individual can do on their own. […] Demonstrate how to use an incentive spirometer. […] Outline prevention measures the individual can take. […] Identify signs and symptoms to indicate when the individual should seek medical attention.
  • #54 Nursing care plan for atelectasis
    https://nursipedia.com/nursing-care-plan-atelectasis/
    Nursing diagnosis may include Impaired gas exchange, Activity intolerance, Ineffective breathing pattern, Risk for infection, Pain, Diaphoresis, Restlessness, Decreased cardiac output, Anxiety and Risk for impaired tissue integrity. […] The patient will be able to demonstrate improved gas exchange (oxygen saturation and/or ventilation) with no adverse effects; improved activity tolerance; effective breathing patterns; and reduced risk of infection. […] Interventions involve application of skills and strategies to improve oxygenation, expand alveolar surface area, mitigate the effects of affected tissue, and assist the patient in making lifestyle changes. Oxygen therapy, chest physiotherapy, incentive spirometry, use of air nebulizers, assisted cough, proper positioning, and ambulation may be used to improve alveolar expansion. To reduce the risk of infection, proper hygiene, adequate nutrition, and monitoring of vital signs are essential.
  • #55 Atelectasis Care Plan for Nursing Students – Straight A Nursing
    https://straightanursingstudent.com/atelectasis-care-plan-for-nursing-students/
    Getting patients up and moving around is going to increase their respiratory drive and help them keep their lungs inflated. […] You will likely include atelectasis in many care plans for patients, especially post-surgical ones. […] Nursing Diagnosis: Impaired gas exchange secondary to shallow respiratory depth as evidenced by O2 saturation 88% on RA. […] Nursing Interventions: Teach patient how to use incentive spirometer, pain medication to support deep breathing, ambulate 3x/day, encourage patient to cough/deep breathe, assess O2 saturation, assess lung sounds. […] SMART objective: By the end of shift, O2 saturation will be > 95% on RA. […] Nursing Diagnosis: Risk for infection secondary to decreased respiratory depth and immobility. […] Nursing Interventions: Teach patient how to use incentive spirometer, pain medication to support deep breathing, ambulate 3x/day, encourage patient to cough/deep breathe, monitor temperature, monitor WBC, monitor chest X-ray, assess lung sounds, assess respiratory depth. […] SMART objective: By post-op day 3, patient will have clear lung x-ray showing no development of pneumonia.
  • #56 Nursing care plan for atelectasis
    https://nursipedia.com/nursing-care-plan-atelectasis/
    Rationale behind nursing interventions includes increasing the amount of oxygen available to the patient, reducing secretion production, improving the efficiency of coughing, and allowing the patient to assume postures that reduce the air remaining inside the tunnel. All of these help to increase the alveolar surface area and therefore improve gas exchange. […] Evaluation of the care plan involves monitoring changes in the patients chest wall movement and ability to tolerate activities while receiving oxygen therapy. Improve oxygen saturations and resolution of symptoms such as pain and anxiety indicate that the care plan is successful. […] Nursing care plans for atelectasis require an understanding of the underlying factors contributing to the disease, the desired outcomes, and interventions that must be implemented in order to achieve these outcomes. Monitoring the patient for signs of distress and evaluating the response to interventions will help the nurse make an informed decision about whether the care plan is successful.
  • #57 Atelectasis: Causes, Symptoms, Diagnosis & Treatment
    https://my.clevelandclinic.org/health/diseases/17699-atelectasis
    Most of the time, atelectasis is reversible once the cause is treated. Most people recover quickly and have no serious lasting effects. In people who have a long-lasting (chronic) condition, further treatment may be needed to manage the underlying cause of atelectasis. […] The best way to take care of yourself is to follow your healthcare providers recommendations for care after surgery. Make sure you manage any underlying conditions that can increase your risk of atelectasis.
  • #58 Atelectasis: Types, Causes, Symptoms, Treatment
    https://www.webmd.com/lung/atelectasis-facts
    Atelectasis treatments include: […] Physiotherapy such as tapping on your chest to break up mucus, lying on one side or with your head lower than your chest to drain mucus, and exercises to help you breathe better. […] If you dont treat atelectasis, it can lead to complications, including: […] Pneumonia (mucus can cause an infection in your lung). […] Some steps may help you prevent atelectasis before and after surgery: […] Ask your doctor about deep breathing exercises and coughing after you have surgery. […] Your outlook depends on several factors, including the cause of your atelectasis. […] After treatment, a collapsed lung usually begins working normally again. […] But if left untreated, it can lead to more health problems. […] Get medical help immediately if youre having any trouble breathing, especially after surgery.
  • #59 Atelectasis: Definition, types, causes, and treatments
    https://www.medicalnewstoday.com/articles/atelectasis
    Some methods may also help prevent the risk of developing atelectasis, especially before surgery or medical procedures involving sedation. […] Atelectasis usually resolves itself with time or treatment, while lung or airway collapse is reversible. […] However, if atelectasis is left undiagnosed or untreated, serious complications can develop. These can be potentially fatal, including but not limited to respiratory infections such as pneumonia and respiratory failure. […] Most people recover from atelectasis with proper treatment within 24 hours. However, without medical intervention, atelectasis can lead to serious complications, including death.
  • #60 Nursing Care Plan For Atelectasis – Made For Medical
    https://www.madeformedical.com/nursing-care-plan-for-atelectasis/
    The nursing care plan for atelectasis plays a vital role in effectively managing this condition, promoting optimal respiratory function, and enhancing the overall well-being of individuals affected by atelectasis. Through comprehensive assessment, evidence-based interventions, patient education, and collaboration with the healthcare team, nursing professionals contribute to the optimization of patient outcomes and quality of life. […] In conclusion, a well-structured nursing care plan for atelectasis is crucial in managing the condition, preventing complications, and promoting optimal respiratory health. Through comprehensive assessment, evidence-based interventions, patient education, and collaboration with the healthcare team, nursing professionals contribute to the overall well-being and quality of life of individuals affected by atelectasis. Regular evaluation and modification of the care plan based on individual patient needs ensure that care remains individualized and responsive to changes in the disease process.