Pleural effusion is an abnormal collection of fluid in the pleural space between the lungs and chest wall. It is usually caused by underlying conditions that interfere with fluid drainage from the pleural space. There are two main types of pleural effusions - transudative effusions which contain low-protein fluid seen in conditions like heart failure, and exudative effusions which are high-protein fluids associated with inflammation from sources such as infection or cancer. Diagnosis involves imaging tests and thoracentesis to analyze the fluid. Treatment focuses on resolving the underlying cause, relieving symptoms, and preventing reaccumulation of fluid through procedures like chest tube drainage or pleurodesis.

1. BY:
-M.PRADEEP
M.Sc.Nursing
2nd year

2.  Pleural effusion, a collection of fluid in the pleural
space, is rarely a primary disease process but is usually
secondary to other diseases
 'The pleural space normally contains only about 10-20
ml of serous fluid .

3.  Pleural fluid normally seeps continually into
the pleural space from the capillaries lining
the parietal pleura and is reabsorbed by the
visceral pleural capillaries and lymphatic
system
 Any condition that interferes with either
secretion or drainage of this fluid leads to
pleural effusion

4. Pleural effusion is a collection of
abnormal amount of fluid in the
pleural space

5.  The estimated prevalence of pleural effusion
is 320 cases per 100,000 people in
industrialized countries, with a distribution
of etiologies related to the prevalence of
underlying disease.

6.  Smoking and drinking alcohol
 Any previous complaint of high blood pressure
 History of any contact with asbestos
 Congestive heart failure
 Pneumonia
 Pulmonary embolism
 malignancy

8.  Transudative effusions
 Exudative effusions

9.  Transudative effusions also known as
hydrothoraces, occur primarily in
noninflammatory conditions; is an
accumulation of low-protein, low cell
count fluid

10.  lncrease hydrostatic pressure found in heart
failure (most common cause of pleural
effusion)
 Decrease oncotic pressure ( From
hypoalbuminemia) found in cirrhosis of liver or
renal disease.
 In this condition, fluid movement is faciliated
out of the capillaries and into the pleural space

13.  Exudative effusions occur in an area of
inflammation; is an accumulation of high-protein
fluid.
 An exudative effusion results from increased
capillary permeability characteristic of
inflammatory reaction.
 This types of effusion occurs secondary to conditions
such as pulmonary malignancies, pulmonary
infections and pulmonary eymbolization.

14.  Disseminated cancer (particularly lung and
breast), lymphoma
 Pleuro-pulmonary infections (pneumonia)
 Heart failure, cirrhosis, nephrotic syndrome
 Other conditions sarcoidosis, systemic lupus
erythematosus(SLE)
 Peritoneal dialysis

19.  Chest CT scan – Fine needle aspiration
 MRI
 Bronchoscopy/Thoracoscopy
 Sputum cytology
 Thoracentesis biochemical , bacteriologic
 Cytologic studies of pleural fluid

20.  The objectives of treatment are to discover
the underlying cause, to prevent
reaccumulation of fluid, and to relieve
discomfort, dyspnea , and respiratory
compromise

21.  Treatment is aimed at underlying cause
(heart disease, infection).
 Thoracentesis is done to remove fluid,
collect a specimen, and relieve dyspnea

22.  Chest tube drainage
 radiation
 Chemotherapy
 surgical pleurectomy
 pleuroperitoneal shunt
 pleurodesis

23.  Permanent decrease in lung function
 Lung scarring
 Empyema
 Sepsis(blood infection)
 Large effusion could lead to respiratory
failure

24.  Obtain history of previous pulmonary condition
 Assess patient for dyspnea and tachypnea
 Auscultate and percuss lungs for abnormalities
 Assist with thoracentesis if indicated
 Maintain chest drainage as needed
 Administer prescribed analgesic
 Observe patient’s breathing pattern , oxygen
saturation

25.  Ineffective breathing pattern related to collection
of fluid in pleural space as evidenced by dyspnea
 Impaired gas exchange related to ineffective
breathing pattern as evidenced by accesory
muscle use
 Anxiety related to diagnosis and therapeutic
procedure (thoracentesis , chest drainage)
 Risk for infection related to introduction of foreign
object (thoracentesis needle, chest tube) in to
chest cavity

26.  Chintamani,lewis,heitkemper,dirksen,O’Brien and
Bucher.(2011). Lewis’s Medical surgical Nursing ;
Assessment and management of clinical problems , 7th
edition , pg no 595
 Suzanne C.S., Brenda G.B., Janice L.H., and kerry
H.C.Brunner & Suddarth’s textbook of Medical-
Surgical Nursing; 11th edition, pg no – 540
 Lippincott Manual of nursing practice(2010). William
and wilkins. Nineth edition , Pg no - 302