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Questions and Answers
A patient undergoing thoracentesis becomes hypotensive and diaphoretic. Which action should the nurse perform first?
A patient undergoing thoracentesis becomes hypotensive and diaphoretic. Which action should the nurse perform first?
- Administer a bolus of intravenous fluids.
- Stop the fluid removal and monitor vital signs. (correct)
- Increase the oxygen flow rate.
- Notify the health care provider immediately.
During a thoracentesis, a patient reports sharp, sudden chest pain and shortness of breath. What immediate complication should the nurse suspect?
During a thoracentesis, a patient reports sharp, sudden chest pain and shortness of breath. What immediate complication should the nurse suspect?
- Pneumothorax. (correct)
- Bronchospasm.
- Pulmonary edema.
- Intravascular fluid shift.
A nurse is preparing a patient for a thoracentesis. What position should the nurse assist the patient into if they are unable to sit upright?
A nurse is preparing a patient for a thoracentesis. What position should the nurse assist the patient into if they are unable to sit upright?
- Side-lying on the affected side with the head of the bed flat.
- Prone with pillows under the abdomen.
- Side-lying on the unaffected side with the head of the bed elevated 30 degrees. (correct)
- Supine with knees flexed.
Following a thoracentesis, the nurse assesses the patient and notes asymmetrical chest expansion, continuous coughing, and decreased breath sounds on the affected side. What should the nurse consider as a priority?
Following a thoracentesis, the nurse assesses the patient and notes asymmetrical chest expansion, continuous coughing, and decreased breath sounds on the affected side. What should the nurse consider as a priority?
After a thoracentesis, the physician orders a chest x-ray. What is the primary reason for this order?
After a thoracentesis, the physician orders a chest x-ray. What is the primary reason for this order?
Flashcards
Thoracentesis
Thoracentesis
A procedure where a needle is inserted into the chest wall to remove fluid from the pleural space.
Diagnostic uses of fluid removal
Diagnostic uses of fluid removal
Analyzing pleural fluid for specific gravity, cell counts, protein, glucose, pathogens, and abnormal cells.
Therapeutic uses of fluid removal
Therapeutic uses of fluid removal
To maintain patient safety/comfort and for medication instillation into the pleural space.
Nursing interventions for thoracentesis
Nursing interventions for thoracentesis
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Post-thoracentesis care
Post-thoracentesis care
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Study Notes
- Thoracentesis involves puncturing the chest wall with a needle to aspirate fluid from the pleural space.
- This procedure serves therapeutic purposes (fluid removal) or diagnostic purposes (biopsy specimen).
Diagnostic Indications
- Examination of pleural fluid determines specific gravity, white and red blood cell counts, protein, and glucose levels.
- Fluid is cultured to detect pathogens and checked for malignant cells.
- Record the fluid's gross appearance, quantity, and thoracentesis site.
Therapeutic Indications
- Removal of fluid poses a threat to the patient’s safety.
- Instillation of medication into the pleural space.
Nursing Interventions
- Explain procedure to patient and obtain written consent.
- Relieve patient’s anxiety.
- The procedure is typically performed in the patient's room.
- Position the patient sitting on the edge of the bed with head and arms resting on a pillow or turn to unaffected side with the head of the bed elevated 30 degrees if the patient cannot sit up.
- Monitor vital signs, general appearance, and respiratory status throughout the procedure.
- Fluid removal is typically limited to 1300 mL to mitigate the risk of intravascular fluid shift and pulmonary edema.
- After thoracentesis, position the patient on the unaffected side.
- Label the specimen and send it immediately to the laboratory.
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