Atelectasis

Mr. Jones, a 68-year-old male, underwent an open cholecystectomy yesterday. He has a history of COPD and smokes one pack of cigarettes per day. On your morning assessment, you note shallow respirations, a weak cough, and a temperature of 100.8∘F (38.2∘C). His oxygen saturation is 90% on room air. Auscultation of his lung fields reveals diminished breath sounds in the bilateral lower lobes.

Based on Mr. Jones's presentation, which of the following risk factors is most contributing to his development of atelectasis?

• A. Age

• B. History of COPD

• C. Surgical incision pain

• D. Smoking history

A 42-year-old female presents to the emergency department with sudden onset of shortness of breath and pleuritic chest pain after a prolonged flight. Her vital signs are: HR 110, RR 28, BP 130/80, SpO2​ 92%.

What is the most appropriate diagnostic test to confirm the presence of atelectasis in this patient?

• A. Arterial Blood Gas (ABG)

• B. Sputum culture

• C. Chest X-ray

• D. Pulmonary function tests (PFTs)

A 75-year-old female is admitted to the medical floor with a new onset of altered mental status and a productive cough. Her chest X-ray shows diffuse infiltrates in the right lower lobe, and her oxygen saturation is 88% on room air. The physician suspects atelectasis and pneumonia.

Which of the following is the priority nursing intervention for this patient to address the suspected atelectasis?

• A. Administer broad-spectrum antibiotics as ordered.

• B. Initiate incentive spirometry every hour while awake.

• C. Position the patient in a high-Fowler's position.

• D. Prepare the patient for a bronchoscopy.