Pleural Effusion
1.Mr.Das, aged 45 years is admitted with the diagnosis of pleural effusion. Answer the following :
a) Define pleural effusion (1)
b) Mention the types of pleural effusion (2)
c) List down the clinical manifestations of pleural effusion (2)
d) Plan a nursing care for Mr.Das applying the nursing process (7)
Definition
collection of fluid in the pleural cavity which is formed by the visceral and parietal layers of the pleura inside the thoracic cavity.
Types of pleural effusion
There are two types of pleural effusion: the transudate and the exudate
Clinical manifestations of pleural effusion
Dyspnea - most common symptom
Fever, chills, pleuritic pain - pneumonia
mild, nonproductive cough
chest pain
production of purulent or bloody sputum - pneumonia or an endobronchial lesion
constant chest wall pain - Cancer
Pleuritic chest pain - pulmonary embolism or inflammatory process
Systemic toxicity evidenced by fever weight loss inanition suggesting empyema.
Decreased breath sounds
Dullness to percussion
Decreased tactile fremitus
Egophony (E-to-A change)
Pleural friction rub
Shift of trachea, mediastinum
Nursing Care
Implement medical regimen relevent to the underlying disease
Prepare and position the patient for thoracentesis
Support the patient throughout the procedure (sedate, prevent shock during puncture of pleura - keep vein patent with Ringer's lactate or saline)
Manage pain
Assist the patient to position himself in the least painful posture
Take care of the water seal drainage system if present
Record drainage
