Unit 4 Chapter 24 Pleural Effusion Flashcards
What is Pleural Effusion?
fluid in between the pleural space,Pleural effusion is a collection of fluid around your lungs.
pleural effusion puts pressure on the lungs
^disrupts lung expansion and gas exchange in Alveoli
^lungs get smaller
What are the types of Pleural Disorders
-Pneumothorax: air in pleural cavity
-Hemothorax: blood in pleural cavity
Pleural effusion: fluid in between pleural space
What type of fluid can be in the pleural space for Pleural effusion
- Pleural effusion –
Transudative or Exudative Empyema- thick, purulent
fluid - Hemothorax – blood
Transudative Pleural Effusion
Fluid of this kind comes from cirrhosis or heart failure, for example. This type of pleural effusion happens when there’s an increase in pressure from the fluid.
Exudative Pleural Effusion
Fluid of this kind comes from cancer or an infection, for example. This type of pleural effusion happens because too much fluid is getting through your smallest blood vessels or your lymphatic system isn’t draining enough.
What are the signs and symptoms of pleural effusion?
CRACKLES
-dyspnea
-sob
-chest pain
-pleuratic chest pain
pleuratic friction rub
Your patient is scheduled for an x-ray for a suspected Pleural effusion due to his primary diagnosis of lung cancer.
What would you suspect to see on the x-ray?
A. white large spot of where the fluid is detected
B. black large spot of where the fluid is detected
C.red large spot of where the fluid is detected
D. yellow large spot where the fluid is detected
A. white large spot of where the fluid is detected
What is the treatment of choice for pleural effusion?
THORACENTESIS
What is a Thoracentesis
Thoracentesis is the needle aspiration of pleural fluid or air from the pleural space for diagnostic or management purposes.
Preop care and patient teaching for Thoracentesis
Make sure content is signed
Assume a leaning over bed side table position Nurse stands in front of patient to make sure they don’t fall over**
FIRST
Assess allergy to local anesthetic
Educate the patient on tingling sensation due to administration of a local anesthetic agent and a feeling of pressure once needle is advanced in the chest
DO NOT MOVE , COUGH, OR DEEP BREATHING DURING PROCEDURE TO AVOID PUNCTURE OF THE PLEURA OR LUNG
Nursing Interventions and Considerations Intraoperational Thorancentesis;
Keep the patient informed of the procedure while observing for shock, pain, nausea, pallor, diaphoresis, cyanosis, tachypnea, and dyspnea.
Post Op Care Thoracentesis
After thoracentesis, a chest x-ray is performed to rule out possible pneumothorax and mediastinal shift (shift of central thoracic structures toward one side).
Monitor vital signs, and listen to the lungs for absent or reduced sounds on the affected side. Check the puncture site and dressing for leakage or bleeding.
Urge the patient to breathe deeply to promote lung expansion.
Document the procedure,
*including the patient’s response; the volume and character of the fluid removed;
*any specimens sent to the laboratory;
*the location of the puncture site; and respiratory assessment findings before, during, and after the procedure
Which of the following is a complication of Thoracentesis?
A. WBC 9,000
B. Subcutaneous emphysema
C. clear lungs
D. Jugular vein distention
B. Subcutaneous emphysema
Assess for complications,
* such as reaccumulation of fluid in the pleural space,
* subcutaneous emphysema,
* infection, and
* tension pneumothorax.
What is Subcutaneous Emyphysema
Subcutaneous emphysema is the presence of air in the tissue layers of the skin and usually is seen as skin swelling around the puncture site.
HOW DOES IT SOUND
Air in these tissues makes a crackling sound when pressure is applied to it.
Why is Subcutaneous Empysema considered a complication of Thoracentesis?
The presence of subcutaneous emphysema may indicate a persistent air leak caused by a puncture that tears the pleura.
When confined to a small area, the leak may not require treatment. However, when the affected area increases to include the neck tissues, the patient’s airway could be affected.
