Assessing a client who has developed atelectasis postoperatively, the nurse will most likely find:
A. A flushed face.
B. Dyspnea and pain.
C. Decreased temperature.
D. Severe cough and no pain.
Correct Answer: B. Dyspnea and pain
Atelectasis is a collapse of the alveoli due to obstruction or hypoventilation. Clients become short of breath, have a high temperature, and usually experience severe pain but do not have a severe cough. The shortness of breath is a result of decreased oxygen-carbon dioxide exchange at the alveolar level. Postoperative atelectasis typically occurs within 72 hours of general anesthesia and is a well-known postoperative complication.
Option A: The definition of atelectasis is a partial collapse of the lung. It can cause people to feel short of breath. It can be a consequence of several different processes, most commonly when there is a poor inspiratory effort, an obstruction blocking airflow into the lung, extra pressure exerted on the outside of the lung, or deficient production or function of a specific protein in the lung.
Option C: Postoperative fever has historically been attributed to atelectasis, but there is no evidence supporting the finding that atelectasis is a causative mechanism for fever. For patients with atelectasis, the prognosis varies greatly, and the primary determination is the underlying etiology and patient co-morbidities.
Option D: Inadequate pain control can contribute to the development of atelectasis by inducing shallow breathing (“splinting”) and/or inhibiting coughing. Typically, atelectasis is asymptomatic. However, a patient might also present with decreased or absent breath sounds, crackles, cough, sputum production, dyspnea, tachypnea, and/or diminished chest expansion.
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