Atelectasis Pathophysiology and Clinical Manifestations

ATELECTASIS

Pathophysiology

• Pressure causes atelectasis from pleural effusion, pneumothorax, or hemothorax.

Clinical Manifestations

• Symptoms include insidious dyspnea, cough, and sputum production.
• Acute cases present tachycardia, tachypnea, pleural pain, and central cyanosis.
• Chronic cases may resemble acute symptoms with possible pulmonary infection.

Assessment & Diagnostic Findings

• Increased work of breathing and hypoxemia are key identifiers.
• Decreased breath sounds and crackles over affected lung areas.
• Chest x-ray can suggest atelectasis before symptoms appear.
• Pulse oximetry may show oxygen saturation below 90%.

Prevention

• Frequent turning and early mobilization are critical.
• Lung expansion strategies include using an incentive spirometer and voluntary deep breathing.
• Effective secretion management is essential.

Management

• Focus on improving ventilation and removing secretions.
• First-line measures include turning, ambulation, and lung volume expansion.
• Multidisciplinary approach known as ICOUGH.
• Techniques may involve PEEP, CPAP, bronchoscopy, and thoracentesis.

ACUTE TRACHEOBRONCHITIS

Pathophysiology

• Acute inflammation affects the trachea and bronchial tree, often leading to mucopurulent sputum.
• Potential causes include infection and inhalation of irritants.

Clinical Manifestations

• Initial symptoms include dry cough, scanty mucoid sputum, sternal soreness, fever, and malaise.
• As the condition progresses, patients may experience shortness of breath, noisy breathing, and purulent sputum.
• Severe cases may lead to blood-streaked secretions.

Medical Management

• Treatment typically involves antibiotics with supportive care.
• Procedures like suctioning and bronchoscopy may be necessary for secretions.
• Cool vapor therapy, steam inhalations, and analgesics can be helpful.

Nursing Management

• Encourage bronchial hygiene, including fluid intake and coughing exercises.
• Assist patients in maintaining an upright position.
• Educate on medication adherence and the importance of rest.

PNEUMONIA

Classification

• Four types: Community-Acquired Pneumonia (CAP), Health Care–Associated Pneumonia (HCAP), Hospital-Acquired Pneumonia (HAP), Ventilator-Associated Pneumonia (VAP).

Pathophysiology

• Results from normal flora, aspiration, underlying conditions, or bloodborne pathogens entering the lungs.
• Increased white blood cells and inflammatory response in the alveoli disrupt normal gas exchange.

LUNG ABSCESS

Prevention

• Adequate antibiotic therapy prior to dental procedures for at-risk patients.
• Good dental hygiene is crucial.

Medical Management

• Focus on drainage of the abscess and may require pulmonary resection if complications arise.
• IV antibiotics such as Clindamycin, Ampicillin-sulbactam, and Carbapenems used for treatment.
• Treatment could extend over weeks, transitioning from IV to oral antibiotics.

Nursing Management

• Administer prescribed antibiotics and monitor for side effects.
• Initiate chest physiotherapy to aid in drainage.
• Encourage high-protein and high-calorie nutrition and provide emotional support.

PULMONARY TUBERCULOSIS

Assessment & Diagnostic Findings

• Confirmed through positive skin or blood test, sputum culture for acid-fast bacilli, and chest x-ray.
• Mantoux test utilizes tuberculin to check for immune response.

Tuberculin Skin Test

• Reaction of 5 mm or greater may indicate significance based on risk factors.
• A significant reaction does not confirm active disease but indicates exposure.

Medical Management

• Treated with Anti-TB drugs over 6 to 12 months, with potential pleural effusion as a complication.

PLEURAL EFFUSION

Pathophysiology

• Fluid can be clear, bloody, or purulent caused by various underlying conditions.
• Classifications include transudate (common in heart failure) and exudate (due to inflammation or malignancy).

Clinical Manifestations

• Symptoms often stem from underlying diseases, with pneumonia causing fever and pleuritic pain.
• Larger effusions lead to significant dyspnea while smaller ones may cause minimal symptoms.

Assessment & Diagnostic Findings

• Physical exam reveals decreased breath sounds and possible tracheal deviation.
• Confirmed through imaging and analysis of pleural fluid.

Medical Management

• Treatment goals include identifying causes, preventing fluid re-accumulation, and relieving symptoms.
• Specific therapies are tailored to underlying causes of the effusion.

This quiz covers the pathophysiology, clinical manifestations, and diagnostic findings associated with atelectasis. It explores the pressure factors leading to the condition as well as the symptoms to be assessed. Understanding these aspects is crucial for effective diagnosis and management in clinical settings.