Term
| What is a pleural effusion? |
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Definition
| A collection of fluid in the pleural space caused by excess production of fluid in the pleural space or decreased removal of fluid by the lymphatic system. |
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Term
| What are the 2 types of pleural effusion? |
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Definition
| Transudative and Exudative |
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Term
| What is Transudative pleural effusion? |
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Definition
| Caused by Heart failure, hepatic disorders, or pulmonary embolus. The fluid is usually clear and odorless |
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Term
| What is Exudative Pleural effusion? |
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Definition
| Caused by disease that affects the pleural surface or lymphatic system: bacterial pnuemonia, lung abscess, lung cancer, AIDS, or Viral infection. Its fluid is usually cloudy and may have a foul odor |
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Term
| What are the s/s of pleural effusion? |
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Definition
| Dyspnea, Tachypnea, Pleuritic Chest pain, and fever with exudative |
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Term
| What might you find upon physical examintion of a person with pleural effusion? |
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Definition
| Decreased or absent tactile fremitus, no diaphragmatic excursion on affected side, dullness on percussion of affected side, diminished breath sounds on affected side or pleural friction rub |
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Term
| What might the labs and x-ray show on a person with pleural effusion? |
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Definition
| CXR: fluid between lungs and chest wall, labs may show an elevated WBC |
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Term
| What is included in the medical management of pleura effusion? |
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Definition
| Observation on ICU or Telemetry floor, Treat the cause, Put patient on ventilator if in acute respiratory distress, Order meds: corticosteroids, diuretics, vasodilators. May have to perform thoracentesis. |
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Term
| What is included in the nursing assessment for a patient with Pleural Effusion? |
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Definition
| Assess VS and respiratory status. Palpate, percuss, and ausculate |
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Term
| What are 2 nursing diagnoses for patients with pleural effusion? |
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Definition
| Ineffective breathing pattern r/t decreased lung excursion and tachypnea. Pain r/t trasmission and perception of visceral, or ischemic impulses. |
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Term
| What are the required nursing interventions for patients with pleural effusion? |
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Definition
| Promote oxygenation and ventilation, manage ventilator, medicate as ordered and document effects of meds. |
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Term
| What are nursing responsibilities r/t a Thoracentesis? |
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Definition
| Gather equipment, assess VS and Resp. status before, during, and after procedure. Position client in side-lying position (on affected side) with back on edge of bed. |
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Term
| What is the procedure for a thoracentesis? |
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Definition
| It is a sterile procedure, physician inserts a large-bore needle in the pleural space to remove the fluid. Usually no more that 1L is removed at a time. Removal of fluid can cause reexpansion pulmonary edema. Procedure usually takes about 15 minutes, causes discomfort. |
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Term
| What are the nursing responsibilites during a thoracentesis? |
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Definition
| Assist with procedure, measure and record amount of fluid removed, and send to Lab. |
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Term
| What is done after thoracentesis is over? |
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Definition
| Apply an occlusive dressing to site, turn client on unaffected side for 1 hour. |
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Term
| What complications can occur after a thoracentesis? |
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Definition
| Shock: decreased BP, Tachycardia, and clammy skin. Pneumothorax: SOB, dyspnea, decreased breath sounds on affected side. Bleeding: observe site frequently, especially pt is on meds like heparin. Subq emphysema: palpate chest wall to monitor for it. |
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Term
| After a thoracentesis, the patient's RR increases to 26/min. What is the nursing responsibility? |
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Definition
| Check the patient, find the problem. It could be related to anxiety or pain. |
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