Pleural Effusion Flashcards
what does transudative effusion look like
Clear, protein-poor, cell-poor fluid.
what causes transudative effusion
Heart failure (most common), liver cirrhosis, nephrotic syndrome, hypoalbuminemia.
what does exudative effusion look like
Protein-rich fluid due to increased capillary permeability.
what causes exudative effusion?
Infection (pneumonia, TB), malignancy, pulmonary embolism, autoimmune disease.
what does empyema look like
Collection of purulent fluid in the pleural space.
what causes empyema
Pneumonia, TB, lung abscess, infected surgical wounds.
what are the symptoms of empymea
Fever, night sweats, cough, weight loss.
what are the symptoms of pleural effusion
Dyspnea (shortness of breath)
Cough (non-productive)
Decreased or absent breath sounds over the affected area
Occasional sharp, non-radiating chest pain (worsens with inhalation)
what does x ray show
Shows fluid accumulation, blunted costophrenic angle.
what does CT show
Identifies effusion volume and location.
what does thoracentesis show?
Aspiration of pleural fluid for diagnostic testing.
Determines if the fluid is transudative or exudative.
Fluid sent for cytology, protein count, LDH levels, and cultures.
what is the treatment for pleural effusion
Heart failure-related effusion → Diuretics & sodium restriction.
Infectious effusion → Antibiotics (bacterial or TB-related).
Malignant effusion → Palliative thoracentesis, pleurodesis.
what is the treatment for empyema
Antibiotics
Percutaneous drainage or chest tube insertion
Intrapleural fibrinolytic therapy (breaks up thick pus/loculated fluid)
Surgery (decortication) for persistent infection
what do you do pre-procedure of thoracentesis
Position patient upright, leaning over bedside table.
Obtain baseline vital signs and oxygen saturation.
Ensure consent is obtained.
what do you do post procedure?
Monitor for pneumothorax (sudden dyspnea, decreased breath sounds, tachycardia).
Check for bleeding or infection at the site.
Encourage deep breathing exercises to expand the lung.
what chemical pleurodesis?
A chemical agent (e.g., talc, doxycycline, or bleomycin) is instilled into the pleural space to create inflammation and fibrosis, preventing fluid re-accumulation.
when is chemical pleurodesis used?
Used for malignant or recurrent pleural effusions.
what are the side effects of chemical pleurodesis
Fever & chest pain (common).
Pleural inflammation causing temporary respiratory discomfort.
what is the supportive care for pleural effusion
Oxygen therapy for hypoxia.
Analgesics for pain relief.
Monitor hydration & nutrition (patients with empyema or malignancy are often malnourished).
Positioning: Encourage semi-Fowler’s or sitting position to aid lung expansion.
Encourage deep breathing & coughing exercises to prevent atelectasis.
