Download - Atelectasis IN CHILD
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ATELECTASIS
MS.L.SOUNDARYA MSC.NURSING (PEDIATRICS)
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DEFINITION
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• IT is defined as the collapse or closure of the lung resulting in reduced or absent gas exchange. It may affect part or all of one lung. (or)
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• Atelectasis is the collapse or airless condition of the lung with incomplete expansion.
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Causes
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1. congenital/ primary Atelectasis- preterm or LBW baby.
-due to immaturity of respiratory of muscle, alveolar ducts abnormality, any pulmonary disorders.
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2. Acquired or secondary Atelectasis:
bronchial obstruction due to foreign body
excessive secretionsMucus plugsTumorsEnlargement of lymph nodes or heart pleural effusionPneumothorax, tension cyst
prolonged anesthesia or abdominal surgery.
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PATHOPHYSIOLOGY
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PRIMARY SECONDARYALVEOLI FAILS TO EXPAND# premature -Because of immaturity of diaphragm & other respiratory muscles, hypermoblity of the bones.# due to sedation of the mother before delivery or brain injury of the newborn# a mucus or meconium plug may cause atelectasis# neonates –lungs are not expanded normally, the acidosis becomes more severe, possibly with pH values of below 7.o
ALVEOLI COLLAPSE After they have once been expanded by air.
# this may occur when the infant or child has pulmonary disease or has aspirated mucus or a foreign body.
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Clinical manifestations• Rapid bronchial occlusion with a large
area of lung collapse causes;• chest pain on the affected side, • retractions,• sudden onset of dyspnea, tachypnea,• Cyanosis, • Coughing,
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• Rapid, shallow breathing• Hypotension, tachycardia,• fever, and shock may also occur. • Irritation in the right middle and
right lower lobe bronchi may cause -severe, hacking, nonproductive
cough.
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DIAGNOSTIC EVALUATION
History collection Physical examination Chest x-ray CBP CUA sputum test c/s
AFB staining
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CT-chest /CT- abdomen Bronchoscopy Radiography oximetry
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COMPLICATIONS
• EMPHYSEMA • BRAIN ABCESS• FIBROSIS• INFECTIONS
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PROGNOSIS• GOOD • POOR MAY FOUND IN MASSIVE
BACTERIAL ATELECTASIS
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NURSING MANGEMENT• Early recognition of atelectasis•Semi fowlers positioning should be maintained.• oxygen therapy
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Suction and postural drainage may be used to reduce the amount of mucus in the respiratory tract.
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• Increased humidity in the environment can prevent the drying of secretions and the formations of bronchial plugs.•Prevent secondary infections.•Prevent respiratory distress.
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NURSING DIAGNOSIS Ineffective breathing pattern related to:
• Hypoxia/inflammatory process• Neuromuscular impairment• Pain• Musculoskeletal impairment• Tracheobronchial obstruction• Perception or cognitive impairment• Anxiety• Decreased energy and fatigue• Decreased lung expansion
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Ineffective airway clearance related to:–stasis of secretions associated with
decreased activity, depressed ciliary function resulting from the effect of anesthesia, and a weak cough effort–increased secretions associated with
irritation of the respiratory tract (can result from inhalation anesthetics and endotracheal intubation);
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• Impaired gas exchange related to ventilation/perfusion imbalances associated with atelectasis/hypoventilation or ineffective clearance of secretions.
• Fluid volume excess related to pulmonary interstitium &alveoli as manifested by respiratory rate variation /by auscultation / investigation (chest)
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Ineffective tissue perfusion r/t compromised blood flow r/t respiratory distress syndrome cyanosis of hands, feet, and around mouth.Ineffective thermoregulation r/t immature compensation for changes in environmental temperature. Imbalanced nutrition status less than body requirements r/t poor feeding behavior Risk for impaired parent-infant attachment r/t interruption of bonding process.
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THANK YOU