Pleural Effusion Definition, Etiology, Signs and Symptoms

Pleural Effusion Definition, Etiology, Signs and Symptoms

Pleural Effusion   November 11, 2013

Pleural Effusion Definition

Pleural effusion is buildup of fluid in the pleural space, a primary disease process are rare but usually occurs secondary to other diseases. Effusion may be a clear liquid, which may be a transudate, exudate, or may be blood or pus (Baughman C Diane, 2000)

Pleural effusion is a collection of fluid in the pleural space which lies between the visceral and parietal surfaces, primary disease process is rare but is usually a secondary disease to other diseases. Normally, the pleural space contains a small amount of fluid (5 to 15 ml) serves as a lubricant that allows the pleural surface to move without friction. (Smeltzer C Suzanne, 2002).

Pleural effusion is a term used for the accumulation of fluid in the pleural cavity. (Price C Sylvia, 1995)


Pleural Effusion Etiology

Barriers resorption of fluid from the pleural cavity, because of the dam as in cardiac decompensation, renal disease, mediastinal tumor, Meig syndrome (ovarian tumor) and superior vena cava syndrome.

Formation of excess fluid, due to inflammation (tuberculosis, pneumonia, viral), bronchiectasis, sub-Phrenic amoebic abscess penetrating into the pleural cavity, because the tumor where the incoming fluid and bleeding due to trauma.

Excess fluid can accumulate in the pleural cavity neoplastic disease process, thromboembolic, cardiovascular, and infection. This is caused by at least one of the four basic mechanisms:

• Increase in capillary pressure or subpleural lymphatics.
• Decrease in colloid osmotic pressure of blood.
• Increase in negative intrapleural pressure.
• Inflammatory or neoplastic pleura.

Pleural Effusion Signs and Symptoms

• The existence of liquid deposits resulting in pain due to friction, after fluid lost quite a lot of pain. When a lot of fluid, the patient will be short of breath.
• The existence of the cause of disease symptoms such as fever, chills, and chest pain pleurisy (pneumonia), high heat (cocci), sub-febrile (tuberculosis), a lot of sweat, cough, lots of ripples.
• Tracheal deviation away from sore spots may occur if there is a significant accumulation of pleural fluid.
• Physical examination in the state of lying and sitting would be different, because the liquid will move. The sick will be less engaged in breathing, fremitus weakened (touch and vocals), the region was found percussion dullness, sits in a state of liquid surface forming a curved line (line "Ellis Damoiseu") .
• Was found ; triangle Garland, the percussion area at the top of the line dim timpani "Ellis Domiseu". Triangle "Grocco - Rochfusz", ie volatile region as fluid pushed mediastinum to the other side, this area was found on auscultation with a weakened vesicular rales.
• At the beginning and end of the disease, pleural audible crackles.

Nursing Care Plan for Pleural Effusion

Ineffective Breathing Pattern related to Pleural Effusion

Ineffective Breathing Pattern related to Pleural Effusion

Pulmonary Nursing   September 16, 2013

Nursing Care Plan for Pleural Effusion - Nursing Diagnosis : Ineffective Breathing Pattern

Pleural effusion, sometimes referred to as “water on the lungs,” is the build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing. Normally, a small amount of fluid is present in the pleura.

Some of the more common causes are:

• Congestive heart failure
• Pneumonia
• Liver disease (cirrhosis)
• End-stage renal disease
• Nephrotic syndrome
• Cancer
• Pulmonary embolism
• Lupus and other autoimmune conditions

Other less common causes of pleural effusion include:

• Tuberculosis
• Autoimmune disease
• Bleeding (due to chest trauma)
• Chylothorax (due to trauma)
• Rare chest and abdominal infections
• Asbestos pleural effusion (due to exposure to asbestos)
• Meig’s syndrome (due to a benign ovarian tumor)
• Ovarian hyperstimulation syndrome

Symptoms of pleural effusion include:

• Chest pain
• Dry, nonproductive cough
• Dyspnea (shortness of breath, or difficult, labored breathing)
• Orthopnea (the inability to breathe easily unless the person is sitting up straight or standing erect)

Ineffective Breathing Pattern

Definition : Inspiration and/or expiration that does not provide adequate ventilation

Defining Characteristics :

• Accessory muscle use
• Abnormal heart rate response to activity
• Altered respiratory rate or depth or both
• Assumption of 3-point position
• Decreased minute ventilation
• Decreased vital capacity
• Decreased tidal volume
• Dyspnea
• Nasal flaring
• Prolonged expiratory phase
• Pursed lip breathing

Nursing Diagnosis for Pleural Effusion : Ineffective Breathing Pattern related to decreased lung expansion (accumulation of air / liquid), musculoskeletal disorders, pain / anxiety, inflammatory process.

Possibility evidenced by:

• dyspnoea, 
• tachypnea, 
• respiratory depth changes, 
• use of accessory muscles, 
• impaired development of the chest, 
• cyanosis, 
• abnormal blood gas analysis.

Goal: Effective breathing pattern

Outcomes:

• Showed normal breathing pattern / effective with normal blood gas analysis.
• Free cyanosis and signs of hypoxia symptoms.

Nursing Intervention:

1. Identify the etiology or trigger factor.
2. Evaluation of respiratory function (rapid breathing, cyanosis, changes in vital signs).
3. Auscultation of breath sounds.
4. Note the position of the trachea and chest development, review fremitus.
5. Maintain a comfortable position is usually the head of the bed elevated.
6. Give oxygen via cannula / mask
7. When the chest tube is installed:
   • check the vacuum controller, liquid limit.
   • Observation of air bubbles bottle container.
   • Hose clamp on the bottom of the drainage in the event of a leak.
   • Keep an eye on the ebb and flow of water reservoir.
   • Note the character / number of chest tube drainage.