Nursing Care Plan for Pleural Effusion

Pleural effusion

Pleural effusion is excess fluid that accumulates in the pleura, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during respiration.

Etiology of Pleural Effusion

Various causes of pleural effusion are:

1. Neoplasms, such as bronchogenic and metastatic neoplasms.
2. Cardiovascular, such as congestive heart failure, pulmonary embolus and pericarditis.
3. Diseases of the abdomen, such as pancreatitis, ascites, abscess and Meigs syndrome.
4. Infections caused by bacteria, viruses, fungi, and parasites microbacterial.
5. Trauma
6. Other causes such as systemic lupus erythematosus, rheumatoid arthritis, nephrotic sindroms and uremia.

Signs and Symptoms of Pleural Effusion

1. Cough
2. Dyspnea varies
3. Complaints of chest pain (pleuritic pain)
4. In severe effusions occur protrusion intercostal space.
5. Chest movement was reduced and delayed on the part of the experience effusion.
6. Percussion dims above pleural effusion.
7. Egofoni close above the depressed pulmonary effusion.
8. Diminished breath sounds over the pleural effusion.
9. Fremitus focal and touch reduced.
10. Clubbing is a sign of a real physical bronchogenic carcinoma, bronchiectasis, pulmonary abscess and tuberculosis.

Examination Support

1. Thoracic radiograph
   In the photo seen the loss of thoracic kostofrenikus corner and you will see a curved surface if the amount of fluid is more than 300 cc. The shift of the mediastinum are occasionally found.


2. Thoracic CT scan
   Important in detecting abnormalities of the trachea and branch configuration of the main bronchus, determine the lesions in the pleura and in general reveal the nature and degree of abnormality found in the shadow of the lung and other thoracic tissues


3. Ultrasound
   Ultrasound can help detect pleural fluid that arise and are often used in guiding the insertion of needles to take on torakosentesis pleural fluid.


4. Thoracocentesis

Physical Examination

On physical examination obtained dull percussion, vocals fremitus decline or even disappear asymmetric, noisy breathing also decreased or disappeared. Respiratory movements decreased or asymmetric, occurred in the lower lung, which had pleural effusion. Physical examination was greatly assisted by radiological examination which showed clearly that phrenic costalis picture disappears and the liquid boundary curve.

Nursing diagnoses for Pleural Effusion, that may arise:

1. Ineffective airway clearance related to weakness and poor cough effort.


2. Impaired gas exchange related to the reduced effectiveness of the surface of the lung and atalektasis.


3. Activity intolerance related to general weakness.


4. Imbalanced Nutrition, Less Than Body Requirements characterized by weakness, dyspnea and anorexia.