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32 terms

Pleural effusion

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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