Pleurisy   Inflammation of the pleural space by air, fluid, bacteria, or associated diseases resulting in a severe sharp, knifelike pain Signs and Symptoms - Pleuritic pain, usually occurring in one side only - Pleural friction rub Diagnostic Finding 1. Chest x-ray 2. Sputum exam 3. Thoracentesis 4. Pleural Biopsy Medical Management 1. Analgesics (NSAIDs) 2. Corticosteroids 3. Warm or cold pack on the affected side Nursing Management 1. Turn frequently on the affected side to splint chest wall and reduce stretching of the pleura 2. Splint the rib cage while coughing 3. Warm and cold application -

B. Pleural Effusion and Pneumothorax  Pleural Effusion – accumulation of fluids in the pleural space  Pneumothorax – accumulation of air in the pleural space  Types of Pleural Effusion 1. Hemothorax 2. Pyothorax / Empyema 3. Hydrothorax  Causes 1. Trauma 2. Thoracic surgery 3. Positive pressure ventilation 4. Thoracentesis 5. CVP line insertion 6. Emphysema  Signs and Symptoms - Sudden, sharp chest pain - Tympanic sound on chest - SOB percussion - Anxiety / restlessness - Tachycardia - Diminished / absent breath sounds - Increased RR - Chest tightness - Chest asymmetry - Cyanosis

Monitor VS especially RR when administering Morphine 4. Chest Tube Thoracostomy (CTT) 2. Intubation and mechanical ventilation. Restrict fluid intake if hypervolemia is the cause . Diuretics .Productive cough. Pleuroperitoneal shunt 5. Thoracentesis 3.Abnormal accumulation of fluid in the lung tissue. Oxygen administration 2.Central cyanosis . Medical Management 1. Oxygen therapy 6.Given if fluid overload is the cause 3. A severe. Record thoracentesis output 3. Analgesics  Nursing Management 1.Confused and stuporous  Medical Management 1.DOB . HPN 5. going to x-ray) C. Monitor and report ABG results 4. Pericardial effusion 6. life-threatening condition  Causes 1. Oxygen therapy 5. Pulmonary Edema .g. Assisting in intubation and mechanical ventilation. Kink tube of drainage bottle of CTT when transporting patient (e.Abnormal breath sounds . Positioning technique – High Fowler’s position 2. frothy and blood-tinged . Arrhythmias 4. Vasodilators and inotropic drugs . Surgical pleurectomy 4. in severe cases  Nursing Management 1.Given to improve cardiac function if the cause is cardiac in origin 2. or both. Fluid overload 7. Morphine . Left ventricular failure 3.To reduce anxiety and control pain 4. alveolar space. if respiratory failure occurs 3. CHF 2. Multiple blood transfusion  Signs and Symptoms .