NURS 4526 Lecture Notes - Lecture 6: Pleural Effusion, Pulmonary Pleurae, Chylothorax
Document Summary
Infection that results in purulent exudate (higher sg & contains inflammatory cells: adjacent bacterial pneumonia, rupture of lung abscess, invasion of adjacent infection, chylothorax, lymph fluid, originating from gi tract, trauma, inflammation, m. Clinical manifestations: depends on cause, fever, in(cid:272)reased wbc"s, fluid decreases lung expansion on affected side; decreased movement of chest wall, pleurirtic pain, hypoxemia, dyspnea, dullness on percussion, absent or decreased breath sounds. Increased fremitus above effusion: absent fremitus over effusion, empyema: fever, night sweats, wt loss, cough. Dx & tx: cxr, us, ct, thoracentesis, diagnostic & therapeutic, rapid removal of fluid can cause hypotension, hypoxemia, pulmonary edema, chest tube drainage. Collaborative care: treat underlying cause, pleurodesis: prevent reaccumulation of fluid 2nd to sclerosing pleural space, chest tubes, antibiotics, supportive: analgesia, o2, iv, pneumothorax, presence of air in the pleural space with partial or complete lung collapse. Closed: rupture of bleb on visceral pleura. Open: air enters via opening in chest wall, i. e. , penetrating chest wound.
