Atelectasis

Definition

Atelectasis is the partial or complete collapse of alveoli, impairing ventilation and oxygenation. It is one of the most common postoperative pulmonary complications.

Types

• Obstructive: Mucus plug, tumor, or foreign body blocks airflow.
• Non-obstructive (compression): External pressure from pleural effusion, tumor, or pneumothorax.
• Post-op: Shallow breathing due to pain or immobility.

Signs and Symptoms

Dyspnea, decreased or absent breath sounds over affected area, dullness to percussion, tachypnea, low-grade fever (24 to 72 hours post-op), decreased SpO2, and tracheal shift toward collapse in severe cases.

Nursing Interventions

Incentive spirometry every 1 to 2 hours while awake (goal volume is patient-specific), cough and deep-breathing exercises, early ambulation, adequate pain control to permit deep breathing, and repositioning every 2 hours. Administer bronchodilators, mucolytics, or chest physiotherapy as ordered, for severe atelectasis, bronchoscopy may be needed.

NCLEX Relevance

Classic post-op complication. Incentive spirometry is the textbook intervention.