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What is an abnormal quantity of fluid in the pleural cavity?

Pleural effusion

In pleural effusion what causes the fluid accumulation?

Imbalance between fluid formation and absorption

What are the two types of pleural
effusion?

Transudative and exudative

What are the five characteristics of transudative pleural effusion?

Increased hydrostatic pressure, decreased oncotic pressure, low-protein, the specific gravity, low cell count

What are the six characteristics of exudative pleural effusion?

Increased permeability, high-protein, high specific gravity, high cell count, increased WBCs and purulent

What is the number one cause of an increased hydrostatic pressure?
( Transudative )

CHF

What causes a decreased oncotic pressure?

Kidney or liver disease

What is the fluid that passes through the pores of the membrane, especially those which pass through capillary walls?

Transudate

What is an accumulation of fluid in the cavity, or matter that penetrates through vessel walls into adjoining tissue, or the passing out of pus or serum, or the matter so passed?

Exudates

What is an effusion seen in association with pneumonia?

Parapneumonic diffusion

What is the accumulation of blood in the pleural cavity?

Hemothorax

What is the presence of chyle in the pleural cavity?

Chylothorax

What is the presence of air and fluid in the pleural cavity?

Hydropneumothorax

What is the presence of pus and air in the pleural cavity?

pyopneumothorax

If there is an increased intrapleural
negative pressure would it be transudate or exudate?

Exudate

What are the clinical features of pleural effusion?

Symptoms may be absent
pleuritic chest pain which disappears after the fluid forms and separates the pleural surfaces, and dyspnea which may be severe to massive

What do the physical findings of pleural effusion vary with?

The amount of fluid

Chest expansion

Decreased

Percussion note

dull

Fremitus

Decreased to absent

Breath sounds

Absent
Pleural friction rub above absent breath sounds

Mediastinal shift

Towards the unaffected side

What is the key to diagnosis?

Chest x-ray

What are two key points to diagnose on the chest x-ray?

Blunting of the costophrenic angle and the meniscus around the upper margin

What type of x-ray would you need for small pleural effusion?

Lateral decubitus

What are the three causes of a transudate PE?

CHF, cirrhosis, kidney disease

What are some causes of exudate PE?

Infection, neoplasms, pulmonary emboli,/surgery, systemic disease, intra-abdominal disease, idiopathic

What is the key to diagnosis of either transudative or exudative?

Thoracentesis

What is the management of pleural effusion?

ID and treat the caus, removal of fluid if causing problems, tap a tension hydrothorax, pleurodesis

When is pleurodesis indicated?

When underlying disease is not treatable

What additional signs/symptoms would you have with empyema?

Fever and other signs of infection

What are two rolls of the respiratory therapist in treating pleural effusion?

Supplemental oxygen and do not do CPT

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