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THORACENTHESIS
Click to edit MasterR.N., M.S.N. JORDAN LLEGO, subtitle style

ASSOCIATE PROFESSOR

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thoracentesis

surgical puncture of the chest wall to aspirate fluid or air from the pleural cavity. A pleural effusion is an abnormal accumulation of fluid in the pleural space.

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Indications
Pleural

up

effusion which needs diagnostic work-

Symptomatic

treatment of a large pleural

effusion

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Contraindications
Uncooperative

patient

Uncorrected

bleeding diathesis

Chest

wall cellulitis at the site of puncture

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Materials
Sterile

gloves, thoracentesis tray or:

Prepared Stopcock Blood 18-20 4X4

transfer set gauge 2 angiocatheter

gauze pads, 5 cc syringe with 25- 27 gauge needle, & 22 gauge needle lidocaine

5/8 1%

Betadine

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PROCEDURE
1. Check the doctors order. 2. Identify the client. 3. Asked patient to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if something is not clear. 4. Explain and emphasize the importance of the procedure.

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5. Explain when and where the procedure will occur and who will be present. 6. The patient may receive a sedative prior to the procedure to help the patient relax. 7. Asked the patient to remove any clothing, jewelry, or other objects that may interfere with the procedure. 8. The area around the puncture site may be shaved.

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10. Vital signs (heart rate, blood pressure, breathing rate, and oxygen level) are to be monitored before the procedure 11. Support the client verbally and describe the steps of the procedure as needed. 13. The patient may receive supplemental oxygen as needed, through a face mask or nasal cannula (tube). 14. Observe the client for signs of distress, such as dyspnea, pallor, and coughing

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15. Place the patient in a sitting position with arms raised and resting on an overbed table. 16. The skin at the puncture site will be cleansed with an antiseptic solution. 17. The patient will receive a local anesthetic at the site where the thoracentesis is to be performed. 18. Place a small sterile dressing over the site of the puncture 19. Observe changes in the clients cough, sputum, respiratory depth, and breath sounds, and note complaints of chest pain.

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20. Position the client appropriately 21 Position the patient in a side-lying position with the unaffected side down for an hour or longer. 22. Include date and time performed; the primary care providers name; the amount, color, and clarity of fluid drained; and nursing assessments and interventions provided. 23. Transport the specimens to the laboratory. 24. The dressing over the puncture site will be monitored for bleeding or other drainage.

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25. Monitor patients blood pressure, pulse, and breathing until are stable. 26. Document all relevant information

Thoracentesis.3gp