Nursing 211

N211: Health Differences Across the Lifespan I Atelectasis is the incomplete expansion or collapse of lung tissue resulting from obstructed air passages by secretions or a foreign body. There is localized alveolar collapse that reduces the gas exchange surface of the lungs. Causes include mucous plugs, decreased expansion due to pain, and anesthesia. Atelectasis is a common complication among post-operative and immobile patients. Nursing Assessment Includes diminished or absent bronchial breath sounds, diminished rate and depth of respirations, low grade fever, dyspnea, anxiety, cyanosis, diaphoresis, tachycardia, substernal or intercostal retraction. Diagnostics Chest x-ray reveals an area of collapse. Nursing Diagnosis • Ineffective airway clearance related to obstruction • Impaired gas exchange related to decreased alveolar surface area Nursing Interventions Include prevention of atelectasis, chest physical therapy and general pulmonary hygiene, possible IPPB treatments, supplemental oxygen as indicated, monitor respiratory and oxygenation status, bronchodilators, deep breathing and coughing, administer adequate analgesics, incentive spirometry hourly while awake and frequent position changes. Maintain adequate hydration and nutrition. Ambulation as soon as possible with client condition. 2.15 Croup Syndromes: Laryngotracheobronchitis (LTB), Epiglottitis and Bronchiolitis Laryngotracheobronchitis is a viral infection that causes inflammation, edema and narrowing of the larynx, trachea, and bronchi; affects age groups 3months to 8 years; usually LTB is preceded by a recent upper respiratory infection. LTB is most common in infants and toddlers. LTB is the most common croup syndrome. LTB is usually caused by parainfluenzae virus, influenza A and B, respiratory syncytial virus and mycoplasma pneumoniae. Inflammation and narrowing of the airways cause inspiratory stridor and suprasternal retractions as the child struggles to inhale air; increased production of thick secretions and edema obstruct the airway and cause hypoxia, and CO2 accumulation, and lead to respiratory acidosis and failure. Nursing Assessment

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