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Every individual on Earth, regardless of race, economic status, gender or social status does the same thing every single minute to live – that is to breathe in air. But did you know even how natural and fundamental the process of breathing is, its purpose was unknown to humanity for a long time? It was around the 19th century when scientists started to understand its importance by circling life processes on cells. Breathing supplies the required oxygen to cells and removes excess carbon dioxide from the body – making it an integral part of the metabolic process. Breathing difficulties result in cellular problems and later on death. This is the main reason why during emergent situations, AIRWAY is always a priority. Among other reasons, some clients experience breathing difficulties due to the presence of excess fluid in the pleural space (the space between your chest wall and lungs). Normally, this space contains about 4 teaspoons full of fluid. Excess fluids brought about by lung infections, tumors, heart failure and injury can lead to pleural effusion – the accommodation of fluid in the chest or lungs. Pleural effusion makes breathing taxing and difficult. To make breathing effortless again, the fluid should be removed from the pleural space. This is where thoracentesis comes into the picture. By definition, thoracentesis is the aspiration of fluid or air from the pleural space. It relieves respiratory distress or pulmonary compression by removing those excess fluid or air resulting from the causes mentioned above. Furthermore, thoracentesis allows health professionals to obtain specimens of pleural fluid or tissue for analysis. This procedure is also important in the instillation of chemotherapeutic agents or other medication of pleural agents in the pleural space. Purpose of Performing ThoracentesisThis procedure is performed on clients with various clinical problems. The procedure can either be diagnostically or therapeutically for the:
Contraindication of ThoracentesisClients with bleeding disorders are contraindicated to undergo this procedure. What Happens During The Procedure?Thoracentesis is performed by the physician and is done by inserting a needle and small, flexible catheter (tube) into the pleural space. This is done under the guidance of an ultrasound that gives visualization on the pleural area. The needle and catheter are used to drain the excess fluid in the area. The procedure takes about 30-45 minutes to complete, however, it takes longer if a large amount of fluid needs to be removed. Post-thoracentesis, a chest x-ray is performed to check the amount of fluid removed and assess the client for signs of complications. BEFORE The Procedure
DURING The Procedure
AFTER The Procedure
To prevent pulmonary edema and hypovolemic shock after the procedure, fluid is removed slowly and no more than 1000 ml of fluid is removed during the first 30 minutes. Also, it is vital to check the client for complications post-thoracentesis to provide timely interventions. Which position should the client be placed for a thoracentesis?You will be in a sitting position in a hospital bed. Your arms will be resting on an over-bed table. This position helps to spread out the spaces between the ribs, where the needle is inserted. If you are not able to sit, you may lie on your side on the edge of the bed.
What is the best position for the nurse to place a client for a thoracentesis of the right lung?Best done with the patient sitting upright and leaning slightly forward with arms supported. Recumbent or supine thoracentesis (eg, in a ventilated patient) is possible but best done using ultrasonography or CT to guide procedure.
Which actions would the nurse perform when preparing a patient for a thoracentesis?Week 5 Concepts of Nursing. Which diagnostic test is used to measure the efficiency of gas transfer in the lungs and tissue oxygenation?A gas transfer test measures how your lungs take up oxygen from the air you breathe. The result of the test is called the transfer factor, or sometimes the diffusing capacity. A gas transfer test is sometimes known as a TLco test.
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