A nurse is assessing a client who has developed atelectasis postoperatively. Which of the following findings should the nurse expect?

Choice A rationale A friction rub is a scratching or grating sound heard during auscultation, typically associated with pleurisy or pericarditis where inflamed surfaces rub against each other. Atelectasis involve the collapse of alveoli, which reduces the surface area available for gas exchange. While it may result in diminished breath sounds or crackles in the affected area, a friction rub is not a standard clinical finding specifically indicative of alveolar collapse in postoperative patients. Choice B rationale Atelectasis is the collapse of small airways and alveoli, which leads to a ventilation-perfusion mismatch and reduced oxygenation of the blood. As the functional lung volume decreases, the patient must work harder to breathe, resulting in increasing dyspnea (shortness of breath). This is a common postoperative complication due to shallow breathing from pain or anesthesia, and the body compensates for the decreased gas exchange by increasing the effort and depth of respiration. Choice C rationale In the presence of atelectasis and the resulting hypoxia, the body’s physiological response is to increase the respiratory rate (tachypnea) to compensate for the lost alveolar surface area. A decreasing respiratory rate would be an unexpected and concerning sign of respiratory failure or over-sedation, but it does not directly characterize the clinical presentation of atelectasis. The nurse would monitor for an elevated rate as the patient struggles to maintain adequate oxygen saturation. Choice D rationale Facial flushing is often associated with fever, hypercarbia, or certain allergic reactions, but it is not a primary sign of atelectasis. Patients with significant atelectasis are more likely to exhibit pallor or cyanosis due to inadequate oxygenation of the tissues (hypoxia). Because atelectasis impairs the ability of the lungs to oxygenate blood efficiently, the skin and mucous membranes may appear bluish or pale rather than flushed or red during the assessment.