Pleural Effusions
What is Pleural effusion?
A build up of fluid between the tissues that line the lungs and chest wall.
What is Restricted lung disease?
A chronic condition that limits the lungs' ability to expand during inhalation. Characterized by a decrease in the total volume of air the lungs can hold.
What is a thoracentesis?
An invasive procedure to remove fluid or air from around the lungs.
What is a chest tube?
A surgical drain that is inserted through the chest wall and into the pleural space in order to remove substances such as air, excess fluid, blood, chyle or pus from the intrathoracic space.
What are life style changes a patient can do?
-Smoking cessation
-Blood pressure control
-Weight management
-Stress management
-Diet
-Manage comorbidities
What are the 4 common causes of pleural effusion?
1. Chronic heart failure
2.Cancers
3.Pneumonia
4.Pulmonary embolism
What are 5 diagnostic tests for Restrictive Lung Disease?
1. Pulmonary function test (PFT): decreased TLC(total lung capacity) with preserved FEV1(forced expiratory volume- exhaled/FVC(forced vital capacity) ratio (greater than 70%)
2. Chest X-Ray
3. CT scan
4. Bronchoscopy: looking at air passages
5. Sputum samples for cytology: Screen for infection and cancer
How does a thoracentesis help a patient?
Relieves shortness of breath and pressure
What to do if the chest tube gets removed?
Tubing comes apart: Place end in sterile NS or water and get new set up reconnected
Chest Tube get pulled out: apply 3 sided occlusive dressings and notify provider.
What is a good diet for these patinets?
Plenty of vegetables, fruit, lean protein, limit sugar, fat and alcohol
What are complications of pleural effusion?
-Lung damage
-Infection that can lead abscess (empyema)
-Pneumothorax
What are complications from Restrictive lung disease?
Shortness of breath that can lead to respiratory failure
What are complications of a thoracentesis?
Pulmonary edema, Pneumothorax and Infection
What are the primary risks with chest tube placements?
Bleeding, infection and injury to the lungs/ diaphragm
How much sleep should these patients aim to get a night
7-8 hours of sleep a night
Symptoms of pleural effusion?
-Chest pain, usually a sharp pain that is worse with cough or deep breaths
-Cough
-Fever/ chills
-Hiccups
-Rapid breathing
-Shortness of breath
-Elderly: older the 75
-African Americans
-Females
-Obese
-Smokers
True or false: A thoracentesis is preformed to inflate a collapsed lung
False: it is use to remove excess fluid or air, therefor allowing the to fully expand.
True or False? The chamber is a closed system; therefore, water can not evaorate.
False: Muffler helps decrease evaporation
What are other ways these patients can minimizes risk for recurrent plural effusion?
Frequent hand washing and avoid exposure to viruses or bacteria due decrease immune system
Cardiac vs Pleural pain?
Cardiac: Pressure, squeezing, tightness, burning
Pleural/ Respiratory: Sudden sharp pain, stabbing when inhaling and exhaling
What are the 4 main types of restrictive lung disease?
1. Interstitial lung disease
2. Pulmonary fibrosis
3. Sarcoidosis
4. Lymphangioleiomyomatosis
True or False: Does a thoracentesis always result in chest tube placement?
False: The procedure is to drain air and fluid; it depends on the amount of fluid and usually a chest tube is place only for larger effusions with greater amount of fluid.
What are things patients need to do after chest tube placement?
-Cough, turn, deep breath every 2 hours
-Brace with pillow
-Use incentive spirometer to help expand the lungs and prevent lung atelectasis and decrease other pulmonary complications; such a pneumonia
What is the recovery time post plural effusion?
Dependent on size, severity and overall health but between 2-4 weeks