Pleural effusion is the accumulation of more fluid between the mural and visceral layers of the pleura, and the fluid can be classified as exudate. Exudate is most commonly seen in tuberculosis and can also arise from malignant tumors or other causes. Leaky fluid is mostly caused by cardiac insufficiency, nephrotic syndrome, portal hypertension or mucinous edema. The main clinical manifestations are chest pain, dyspnea, fullness on the affected side with restricted movement of the chest wall, shortness of breath and chest tightness, or even telangiectatic breathing, high fever, tracheal and mediastinal displacement, etc. The main treatment principle is to treat the cause, pumping pleural fluid as well as anti-inflammatory and anti-TB treatment.
Care of pleural effusion
[Assessment
1.Assess the degree and nature of coughing, coughing sputum and dyspnea.
2.Assess the presence or absence of chest pain, the site and nature of pain.
3.Assess vital signs and arterial blood gas indicators.
4.Assess the chest signs, such as turbid sounds on percussion and the clarity of breath sounds.
5.Assess whether the patient with malignant pleural effusion is accompanied by wasting, anemic appearance, cachexia, and enlarged supraclavicular lymph nodes.
6.Assess the patient’s psychological status.
Care]
1.Closely observe the changes of vital signs and pay attention to monitor the changes of body temperature.
2.Give semi-recumbent position, and give oxygen when chest tightness and shortness of breath.
3.Give analgesic when the chest pain is severe.
4.Assist the doctor to draw chest fluid, observe the color and amount of chest fluid and record.
5.If there is closed chest drainage, closely observe whether the drainage is smooth and record the drainage flow.
6.Change the closed chest drainage bottle daily, and operate strictly aseptically to avoid retrograde infection.
7.Encourage patients to rest in bed, and give high protein, high calorie and coarse fiber diet.
8.Do psychological care to eliminate tension.
Health guidance]
1, pay attention to diet, avoid strain.
2. Avoid cold to prevent respiratory tract infection and quit smoking.
3, pay attention to eat more crude fiber, high calorie, high protein diet.
4.Follow the doctor’s instructions and take the medication on time, and have regular outpatient review.
5, once the chest pain, breathing difficulties immediately to hospital treatment.