A client with a history of heart failure and COPD (caused by 60 pack/year smoking) presents to the clinic with the following complaints: auscultation of breath sounds reveal absent/diminished breath sounds in the right lower lobe
Which other manifestations lead the health care provider to suspect the client may have developed atelectasis? Select all that apply.
A) Respiratory rate—32; pulse rate—122 beats/minute.
B) "Having a hard time catching my breath."
C) "Seems like I'm not making much water (decreased urine production)."
D) Using accessory muscles to help him breathe.
E) Copious amounts of thick, green sputum.
Ans: A, B, D
Feedback:
Atelectasis is caused most commonly by airway obstruction rather than a vascular obstruction. The clinical manifestations of atelectasis include tachypnea (respiratory rate of 32), tachycardia (pulse rate of 122) dyspnea (hard time catching breath), cyanosis, signs of hypoxemia, diminished chest expansion, absence of breath sounds, and intercostal retractions (use of accessory muscles). Both chest expansion and breath sounds are decreased on the affected side. There may be intercostal retraction (pulling in of the intercostal spaces) over the involved area during inspiration. Urine production is not related to atelectasis. Copious green sputum is associated with infection.
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