Atelectasis: Nursing Diagnosis And Interventions

Hello nursing students, welcome to this post on the nursing diagnosis and interventions for atelectasis.

In this blog post, we’ll explore the definition and causes of atelectasis and discuss specific nursing diagnoses to which you should pay attention when caring for an individual with this condition.

What Is Atelectasis?

Atelectasis is a condition that occurs when all or part of the lung collapses due to obstruction, inadequate surfactant production, or other causes. It can be caused by mucus plugs in the airways, tumor growths, foreign objects in the airway, or decreased surfactant production.

When you inhale, air fills your lungs. This air travels to tiny sacs in the lungs known as alveoli, enabling oxygen to enter the bloodstream. The enriched blood transports oxygen to all organs and tissues throughout the body.

If your alveoli do not receive enough air to fill up or external pressure pushes down on them, they can collapse (atelectasis). This can happen in a localized area or throughout the lung. If enough of the lungs are impacted, it may lead to an oxygen deficiency in your blood, which can cause serious health issues.

Symptoms of Atelectasis

• Shortness of breath
• Pain in the chest or back
• Coughing up of yellow, green, or bloody mucus
• Wheezing and difficulty breathing
• Fatigue and lack of energy.

Cause of Atelectasis

The cause of atelectasis can be an airway obstruction caused by mucus plugs, tumors, foreign bodies, or decreased surfactant production. It can also be caused by mechanical factors such as high positive end-expiratory pressure (PEEP) and low tidal volume ventilation from ventilators used to help patients with breathing problems.

Complications of Atelectasis

• Hypoxia – Low oxygen levels in the body due to decreased available oxygen within the air sacs.
• Pneumonia- A lung infection caused by bacteria or viruses that can cause inflammation and further reduce the amount of air entering the alveoli.
• Pulmonary hypertension- High lung blood pressure caused by increased pulmonary resistance due to atelectasis.
• Respiratory failure- An inability of the respiratory system to adequately exchange gases between the airways and the bloodstream, resulting in dangerously low oxygen levels.

How is Atelectasis Diagnosed?

A chest X-ray (picture of your lungs) is typically the first step in diagnosing atelectasis. If more detailed visuals are needed, a computed tomography (CT) scan may be performed. Sometimes, your healthcare provider may look inside your lungs with a camera attached to a tube that goes down the throat (bronchoscopy). During bronchoscopy, any existing blockages may be removed.

How is Atelectasis Treated?

Your healthcare provider may monitor cases of atelectasis without treatment, as many of them can resolve independently. Other treatments depend on the cause and extent of the collapse.

Treatments could include:

• Inhaled medications reduce inflammation and help open the airways.
• Deep breathing exercises (incentive spirometry).
• Chest physiotherapy includes breathing exercises or postural drainage (positioning you for easier mucus expulsion).
• Surgery to remove an obstruction if needed.

Nursing Diagnosis for Atelectasis

• Impaired Gas Exchange: This is related to or caused by decreased oxygenation due to incomplete lung expansion.
• Risk for Ineffective Airway Clearance: Related to reduced cough effectiveness, inadequate clearance of secretions, and airway obstruction.
• Acute Pain: Related to chest discomfort and pressure.
• Anxiety: Related to fear of breathing difficulty, shortness of breath, and lack of control.
• Impaired Comfort: Related to labored breathing from increased work of breathing due to atelectasis.
• Risk for Infection: Related to foreign objects or organisms in the lungs.

Atelectasis Nursing Interventions

• Monitor and assess the patient’s respiratory status, including vital signs, blood gases, oxygen levels, and lung sounds/auscultation.
• Encourage deep breathing techniques such as pursed lip breathing and diaphragmatic breathing exercises.
• Teach the patient and family proper coughing techniques to maximize sputum clearance.
• Encourage adequate hydration, nutrition, and rest to help support healing.
• Implement infection control measures (hand hygiene and gloves/gowns) to prevent further complications.
• Administer oxygen therapy as prescribed.
• Position the patient in an upright, semi-Fowler’s position to promote adequate oxygenation and drainage of mucus.
• Provide emotional support and comfort measures as needed.

What Is Bibasilar Atelectasis?

Bibasilar atelectasis may sound like a tongue twister, but it’s a condition that can affect your lungs. It occurs when the tiny air sacs in the lower parts of your lungs collapse, not the whole as atelectasis case, making it harder for you to breathe. It can be caused by various factors, from mucus buildup to a tumor pressing on your lungs. 

Unfortunately, it’s a fairly common condition, but the good news is that it can often be treated with a combination of rest, exercise, and medication. 

If you’re experiencing symptoms of bibasilar atelectasis, such as shortness of breath or chest pain, you must talk to your doctor immediately. With the proper treatment and care, you can breathe easy knowing you’re on the road to recovery.

Causes

The primary cause of bibasilar atelectasis is a blockage in the lower airways. This can be due to mucus buildup, an infection, a tumor pressing on the lungs, or even a foreign object lodged in your airways.

It can also be caused by pleural effusion, a fluid buildup in the pleural cavity. In some cases, surgery or radiation therapy for cancer can also lead to bibasilar atelectasis.

Symptoms

The most common symptom of bibasilar atelectasis is shortness of breath, which can range from mild to severe depending on the severity of the condition.

Other symptoms may include chest pain, wheezing or coughing, fatigue, and tightness in your chest. If you are experiencing any of these symptoms, seeing your doctor immediately is essential.

Treatment

The treatment for bibasilar atelectasis will depend on the underlying cause. Rest and exercise may sometimes be enough to clear out the blockage and restore normal breathing. If an infection is present, antibiotics may be prescribed to treat it.

Bronchoscopy is a surgical process that is taken, in some cases, to remove any foreign objects blocking the airways. Your doctor can also provide oxygen therapy if necessary.

Prevention

The best way to prevent bibasilar atelectasis is to practice good respiratory hygiene and get regular check-ups with your doctor. Keeping your lungs healthy by avoiding smoking and air pollution can also help.

If you are recovering from surgery or radiation therapy, follow your doctor’s instructions carefully to reduce the risk of developing bibasilar atelectasis.

Final Words

We hope you have gained a better understanding of atelectasis and the nursing diagnosis associated with it. With this information in hand, you should be able to create an effective care plan for your patient. Remember to stay up to date with the latest evidence-based guidelines and protocols for treating atelectasis to ensure optimum care and safety of your patient.

Please comment below if you have any questions about atelectasis or want to share your experience caring for a patient with this condition.

References:

1.https://www.ncbi.nlm.nih.gov/books/NBK572133/#:~:text=Atelectasis%20is%20usually%20clinically%20diagnosed,in%20the%20area%20of%20atelectasis.

2. https://my.clevelandclinic.org/health/diseases/17699-atelectasis