most frequent cause is the presence of thick mucous that is not removed by coughing.
Postoperative patients and debilitated bedridden patients are susceptible to obstructive
atelectasis due to inadequate depth of respiration and the accumulation of bronchial
b. If a sudden collapse involving sufficient tissue occurs, the following signs and
symptoms may be present: dyspnea, tachycardia, anxiety, cyanosis, and pleural pain.
The chest wall of the affected side will barely move on respiration.
c. Treatment involves the identification and correction of the underlying cause.
If the presence of air or fluid in the pleural space is causing compression, measures
should be taken to remove the air or fluid by thoracentesis or chest tube insertion.
Bronchial obstruction should be removed by the use of vigorous percussion, coughing,
and postural drainage. Secretions may be loosened and liquefied by the use of
humidification and increased fluid intake.
d. Postoperative atelectasis can be reduced significantly by the use of early
ambulation, incentive spirometery, and a rigorously enforced program of deep breathing
2-44. CHRONIC OBSTRUCTIVE PULMONARY DISEASE.
a. Chronic obstructive pulmonary disease (COPD) is a broad term used to
classify conditions associated with chronic obstruction of the airflow entering or leaving
the lungs. Chronic obstructive pulmonary disease is characterized by increased
resistance to airflow due to one of the following basic conditions:
(1) Excessive secretion of mucous within the airways that is not because of
a specific cause (such as an underlying infection) will obstruct airflow. This is typical of
(2) An increase in the size of the alveoli with a loss of elasticity will increase
airflow resistance. This is the case in emphysema.
(3) Narrowing of the bronchial airways significantly restricts airflow. This
type of obstruction is characteristic of asthma.
b. There are other similar conditions that may be classified as COPD. In all
these conditions, the underlying problem is the same. Altered physiology of the
respiratory structures has caused a chronic airflow problem due to obstruction of part of
the air passageways.
c. Physical examination and patient history will usually identify the altered
physiology at work. Treatment is based upon symptomatic relief, use of controlled
oxygen therapy, and medications to compensate for the altered physiology. Patient
education is important, since there is no cure for these conditions. They are the result