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A pleural effusion is an abnormal accumulation of fluid in the pleural space. .7/28/12 thoracentesis  surgical puncture of the chest wall to aspirate fluid or air from the pleural cavity.

7/28/12 Indications  Pleural up effusion which needs diagnostic work-  Symptomatic treatment of a large pleural effusion .

7/28/12 Contraindications  Uncooperative patient  Uncorrected bleeding diathesis  Chest wall cellulitis at the site of puncture .

& 22 gauge needle lidocaine  5/8”  1%  Betadine . 5 cc syringe with 25.7/28/12 Materials  Sterile gloves.27 gauge needle. thoracentesis tray or:  Prepared  Stopcock  Blood  18-20  4X4 transfer set gauge 2” angiocatheter gauze pads.

3. Explain and emphasize the importance of the procedure. Check the doctor’s order.7/28/12 PROCEDURE 1. . 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. 2. Identify the client.

Explain when and where the procedure will occur and who will be present. jewelry. 8. The patient may receive a sedative prior to the procedure to help the patient relax. 6. The area around the puncture site may be shaved. 7.7/28/12 5. . Asked the patient to remove any clothing. or other objects that may interfere with the procedure.

through a face mask or nasal cannula (tube). 13. blood pressure. and oxygen level) are to be monitored before the procedure 11. such as dyspnea. Support the client verbally and describe the steps of the procedure as needed.7/28/12 10. The patient may receive supplemental oxygen as needed. 14. breathing rate. Vital signs (heart rate. pallor. Observe the client for signs of distress. and coughing .

Place the patient in a sitting position with arms raised and resting on an overbed table. Place a small sterile dressing over the site of the puncture 19. The skin at the puncture site will be cleansed with an antiseptic solution. sputum. Observe changes in the client’s cough. 16. and breath sounds.7/28/12 15. respiratory depth. The patient will receive a local anesthetic at the site where the thoracentesis is to be performed. and note complaints of chest pain. 18. . 17.

. The dressing over the puncture site will be monitored for bleeding or other drainage. Position the client appropriately 21 Position the patient in a side-lying position with the unaffected side down for an hour or longer. and clarity of fluid drained. 23. color.7/28/12 20. the amount. 22. Transport the specimens to the laboratory. the primary care provider’s name. 24. Include date and time performed. and nursing assessments and interventions provided.

Monitor patient’s blood pressure. pulse. and breathing until are stable. 26.3gp .7/28/12 25. Document all relevant information  Thoracentesis.

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