ANJAE KRISTELLE D.

GARIANDO
BSN 3-2
REFLECTIVE ESSAY: PLEURAL EFFUSION

In this video, we have learned about pleural effusion. A pleural effusion is an

accumulation of fluid in the lungs' pleural space. The kind of fluid that is accumulating
helps doctors establish the reason of the effusion. This can be exudative which is
protein rich of greater than 3 grams per liter or transudative which has lower than 3
grams per liter. Exudative causes were inflammation which result to protein leaking out.
It can be also caused by lung cancer, pneumonia, rheumatoid arthritis, and tuberculosis.
On the other hand, transudative causes fluid to move into pleural space. This can be
due to congestive heart failure, hypoalbuminemia, hypothyroidism and Meigs syndrome.
Presentation of the disease would be shortness of breath, dullness in percussion,
reduced breath sounds, tracheal deviation.
Diagnostic procedure includes chest Xray which will show blunting of
costophrenic angle, fluid in lung fissures, large effusions, and tracheal deviation. We
could also take sample of pleural fluid through aspiration or chest drain. For the
management, if there is small effusion, we could do a conservative management as
treating the underlying causes while larger effusion needs drainage like pleural
aspiration and chest drain.
Now let’s talk about empyema, which is an infected pleural effusion. This can be
suspected when a patient has improving pneumonia but still has an ongoing fever.
Aspiration will show pus, low pH, low glucose, and high LDH. It can be treated the same
way as pleural effusion with antibiotics.

As nurses, we have a lot of responsibilities in caring for the patients with pleural
effusion. The nurse plays an important role in explaining, educating, and reassuring the
patient and his or her family about their condition. As we all know, Patients with the
condition frequently experience fatigue. The patient's treatment should be planned such
that he or she has to exert as little effort as possible until the effusion is drained, and
lung function improves. To save energy, the nurse aids the patient with basic care
needs such as bathing and toileting. It is beneficial to position the patient for optimum
lung expansion by seating them up in bed and teaching them how to use the
diaphragm. Pursed lip breathing reduces the sensation of being out of breath and
regulates the respiratory rate. When physical exercise is necessary, the patient must be
taught how to pace himself so that he does not become out of breath. To maximize the
quality of the patient's remaining life duration, referral to hospice and social work is
acceptable. From this, I realized how important our role as nurses to be with the patient
every step of the way. A nurse is a patient's caretaker who assists with physical
requirements, illness prevention, and treatment. They must examine and monitor the
patient in order to make treatment decisions, and they must record any pertinent
information. In the future, we must establish a better nurse – patient relationship so that
we will be able to provide optimum care for the client and in return, they will be satisfied
with the nursing care that we have offered which will help them to have improved
condition.