7 Examination of Pleural Effusion
Chest X-rays are usually the first step for diagnosing pleural effusion, the results of which indicate the presence of fluid. Surface of the liquid contained in the pleural cavity will form a shadow-like curves, the lateral surface area is higher than the medial surface. When the horizontal surface of the lateral to medial sure the air contained in the cavity that can come from outside or inside the lung itself.
Another thing that can be seen in the photograph chest, mediastinal pleural effusion is classified on the opposite side of the liquid. However, if there is atelectasis on the same side with the fluid, mediastinal will remain in place.
2. CT scan of the chest
CT scan clearly depicts the lungs and fluid and can indicate the presence of pneumonia, lung abscess or tumor.
3. Ultrasound chest
Ultrasound can help determine the location of the collection of small amounts of fluid, so that the discharge can be done.
Aspiration of pleural fluid is useful as a tool for diagnostic and therapeutic thoracocentesis should be performed in a sitting position. Location aspiration is at the bottom of the lungs, interrupted ribs to the posterior axillary line 9 with a needle no. 14 or 16. Discharge should be no more than 1000 to 1500 cc in every aspiration, if the aspiration is done at once in large quantities, it will cause pleural shock (hypotension) or pulmonary edema. Pulmonary edema occurs because the lungs are rapidly developing.
Histologic examination of one or a few examples of pleural tissue can indicate 50-75% of cases the diagnosis of pleurisy, tuberculosis, and lung tumors. When the results of the first examination is not satisfactory, it can be re-examined. Biopsy complication was pneumothorax, hemothorax, the spread of infection in the chest wall.
Nursing Diagnosis Pleural Effusion : Ineffective Breathing Patter related to decline in lung expansion secondary to the buildup of fluid in the pleural cavity.
6. Analysis of pleural fluid
Pleural effusion diagnosis based on history and physical examination, and confirmed by chest x-ray. With the lateral decubitus position thoracic images can be seen the presence of fluid in the pleural cavity as at least 50 ml, while the position of the AP or PA with at least as much fluid in the pleural cavity of 300 ml. On chest x-ray AP or PA position angle costophreicus found any that are not sharp.
Bronchoscopy is sometimes done to help find the source of the collected fluid.