Effusion In Patients

Throughout my clinical rotation, the only concern for this patient was pain management and discomfort from the chest tube site. The patient was given Ketorolac for a pain of 4/10 using the numeric pain sale. The patient was also at risk for pneumonia and pressure ulcers from immobility and not coughing/deep breathing. Nursing interventions were getting the patient up to the chair and using the incentive spirometer ten-times per hour. Another concern was SOB and fatigue with activities.

The human body needs fluid in order to live, but sometimes the body can become overloaded with fluid in different areas of the body. In such circumstances, the excess fluid has to be removed. When the space between the chest wall and the lungs, called the pleural space, fills with too much fluid, a thoracentesis is necessary. A thoracentesis is a procedure that is used to relieve the pleural effusion, or

Ibuprofen: antiinflammatory and antipyretic actions; COX-1 and COX-2 inhibitor, nephrotoxicity and GI bleeding are the major side effects (Skidmore-Roth, 2013). Greisman & Mackowiak (2002) stated, “Ibuprofen did not improve survival in patients with sepsis, even though the drug did have a salutary effect on core temperature and metabolic rate” (p. 243). Considering the patient’s risk for renal failure, ibuprofen is not recommended. Moreover, if activated protein C treatment is considered, ibuprofen is contraindicated, since it might increase the risk for internal bleeding. Therefore, acetaminophen is the drug of choice for

Pulmonary edema is life threatening. It can occur suddenly or progress over time. When pulmonary edema develops suddenly it is known as acute pulmonary edema and requires immediate medical treatment. It can be treated with medication and oxygen. The cause of the edema needs to be treated as well (Mayo Clinic Staff).

Pleural effusion in patients with lymphoma may be either due to actual pleural disease or reactive in nature (Fig.37). 18F-FDG

Ineffective airway clearance related to adventitious lung sounds, rhonchi auscultated bilaterally at the patient’s bases as evidence by CT scan displaying pleural effusion and basilar atelectasis. Y.B.’s ability to clear his airway is ineffective due to his current disease state. His alveoli are deflated due to pleural effusion. The pleural effusion is a result of blocked lymphatic drainage from the pleural cavity, possible caused by malignant cells (Lewis, Dirksen, Heitkemper, & Bucher, 2014). The goal for Y.B. is to maintain a clear, open airway, and improvement in lung sounds before discharge. Ensuring the patient uses the upright position, maintaining the head of the bead above 30o, will keep his abdominal contents from inhibiting lung expansion. This intervention will be evaluated by assessing lung sounds, pulse oximetry, assessing if Y.B. is using accessory muscles to breath, and a chest X-ray. In the article titled,

Pneumonia or fluid in pleural space: assess the chest and lungs for breath sounds, respiratory effort, and signs of distress. Impaired tissue perfusion: check pulse ox, capillary refill, extremity warmth, pedal pulses, LOC, and urine output. Reduced urine output is a sign of decreased cardiac

Atelectasis and lobar collapse of mid and lower zones of R lung secondary to sputum plug, sputum retention in R upper zone ? due to chest infection ? due to reduced MCT function due to intubation exacerbated by smoking status. P on cough. Hyperinflation of L lung ? due to emphysemous changes in lungs or due to increased compliance of L lung due to high PIP value and increased VT delivered to this lung. ? renal failure.

You may continue: To have a breathing tube. To receive fluids and medicines through an IV tube. To have a catheter draining your urine.

A common test performed when trying to diagnose respiratory infections is a chest x-ray. When looking at the results of the x-ray in the case study there was interstitial fluid found in the lungs. Looking at Catherine Goodmans text Pathology, PCP is described as cysts that grow and burst with fluid, and giving way to more cysts that continue the cycle. These cysts and their bursting could lead to the fluid found in the x-ray. When looking at TB, the textbook states that the most common things seen in an x-ray would be atelectasis(a burst lung), lesions forming on the lung surface, and solid masses. None of these fit the description. In addition the patient did not mention a prolonged and slowly progressing case. Tuberculosis is noted to work

Pneumothorax and pneumomediastinum are the most related injury with subclavian catheter placement (kornbau, Lee, Hughes, & Firstenberg, 2015). In many cases the catheter or the guidewire may have inadvertently puncture the puncture the pleura space (Darovic, 2002). The risk is higher on patients receiving mechanical ventilation, especially the patients whose lungs are hyperinflated due to high levels of PEEP, resulting in tension pneumothorax (Darovic, 2002). The signs and symptoms associated with a pneumothorax are respiratory distress with increasing shortness of breath and hypotension (Darovic, 2002). Patients that on mechanical ventilation the most common signs are increased peak airway pressures, tracheal shift away from the attempted side absent or unilateral breath sounds with accompanying hypoxemia (Darovic, 2002). The respiratory therapist (RT) should do a complete assessment after CVC especially if pneumothorax is suspected. Proper placement of the CVC with chest radiograph (X-ray) (Darovic, 2002). The only way to confirm the presence of pneumothorax and hemothorax is with X-ray or CT (Korbau, Lee, hughes, & Firstenberg, 2015). The physician must be notified immediately to provide clinical intervention a tension pneumothorax can rapidly become fatal (Darovic, 2002). Prior to the procedure, the patient or surrogate must be informed of the risks and complications associated with

Pleural effusion is defined by Liz Allibone as “an abnormal collection of fluid in the pleural space caused by a variety of mechanisms.” The pleural space is a cavity between the chest wall and the lung that consists of two layers, the parietal pleura and the visceral pleura. These two layers normally have pleural fluid within them to reduce friction during respiration. Allibone quotes about normal pleural fluid levels that “…it is suggested that there is around 0.2-0.4 ml/kg in a healthy adult.”

Pneumothorax occurs when air gets into the pleural space between the two layers, and separates them. Majority of the time only part of the lung collapses, except for in severe cases the whole lung can collapse, therefore it is emptied of air. The types of pneumothorax being discussed are primary spontaneous pneumothorax, secondary traumatic pneumothorax, iatrogenic pneumothorax, and open or tension pneumothorax. Along with the discussion of the pathophysiology, the topics such as diagnostic tests and primary diagnosis, pharmacological interventions, vulnerable groups, and the nursing diagnosis are also examined.

Pleural effusion is usually visualized as an anechoic space between the parietal and visceral pleura. This condition can be obvious in patients with substantial effusion. In other conditions, such as complex effusion and in patients where pleural effusion is suspected, the sonographic technique can benefit from standardized criteria to improve diagnostic accuracy

Pleural infection is a frequent clinical problem associated to an elevated co-morbidity and considerable mortality rate and for these reasons the prompt clinical identifying is mandatory for the therapeutic way. The standard treatment includes broad spectrum and appropriate antibiotics and evacuation of infected pleural fluid (thoracentesis or tube thoracostomy). The appropriate management of complicated parapneumonic effusion or pleural empyema remains controversial. In the exudative stage is often effective the closed-chest drainage, but in fibrino-purulent phase, natural evolution of pleural infected fluid, this practice could not produce the expected results (as resolution of sepsis and complete parenchimal re-expansion) and then necessitates