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PLEURAL EFFUSION
DR.SAMIR JADAV (PT)
DEFINITION
• Pleural effusion is an excessive accumulation of serous
fluid in the pleural space/cavity.
• Normal fluid in cavity : <20 ml
CAUSES
Secondary to condition such as ;
 Pneumonia
 Malignancy of lungs
 Tuberculosis
 Pulmonary infarction
 Lung abscess, etc.
ASSESSMENT (MOCK)
DEMOGRAPHIC DETAILS
CHIEF COMPLAINTS
- Patient complains of pain in chest, which
increases,
during breathing, coughing and even during
sneezing.
- Patient is having difficulty in breathing.
HISTORY
H/O PRESENT ILLNESS:
- Pleural effusion is often secondary to the
conditions such
as pneumonia, etc.
PAST MEDICAL HISTORY
-No other medical conditions in
past.
DRUG HISTORY
FAMILY HISTORY
SOCIAL HISTORY
PERSONAL HISTORY
SUBJECTIVE ASSESSMENT
COUGH : Productive
DYSPNOEA : Present
Grade-2(NYHA scale)
SPUTUM : Purulent
HAEMOPTYSIS : Present
CHEST PAIN : Present, Pleuritic
Assessment : VAS scale
WHEEZE : Present
OTHER SYMPTOMS : Fever, Wt. loss,
Fatigue and weakness.
OBJECTIVE ASSESSMENT
GENERAL OBSERVATION
- Patient seems to be breathless.
LEVEL OF CONSCIOUSNESS
- GCS scale
BODY BUILT
OBSERVATION OF CHEST
CHEST SHAPE :- Normal / depressed on affected
side
CHEST MOVEMENT :- Diminished
BREATHING PATTERN :- According to gender
TYPE OF BREATHING :- Tachypnoea
ON EXAMINATION
(VITALS)
TEMPERATURE :- Normal
RESPI. RATE :- Tachypnea
HEART RATE :-
BLOOD PRESSURE :-
ON PALPATION
TRACHEA : Normal/Central
TENDERNESS : Absent
TVF : Reduced
CHEST EXPANSION : Diminished on affected side
ON PERCUSSION
- Dull note on percussion.
ON AUSCULTATION
BREATH SOUNDS : Bronchial
FOREIGN SOUNDS : Crackles
INVESTIGATIONS
 CBC
 Sputum examination
 X-ray chest
 Thoracoscopy
DIAGNOSIS : Pleural effusion
PT MGMT - SEE ‘PULMONARY DISEASE PT MGMT’
presentation.
PLEURAL EFFUSION PT ASSESSMENT AND MANAGEMENT

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PLEURAL EFFUSION PT ASSESSMENT AND MANAGEMENT

  • 2. DEFINITION • Pleural effusion is an excessive accumulation of serous fluid in the pleural space/cavity. • Normal fluid in cavity : <20 ml
  • 3. CAUSES Secondary to condition such as ;  Pneumonia  Malignancy of lungs  Tuberculosis  Pulmonary infarction  Lung abscess, etc.
  • 4. ASSESSMENT (MOCK) DEMOGRAPHIC DETAILS CHIEF COMPLAINTS - Patient complains of pain in chest, which increases, during breathing, coughing and even during sneezing. - Patient is having difficulty in breathing.
  • 5. HISTORY H/O PRESENT ILLNESS: - Pleural effusion is often secondary to the conditions such as pneumonia, etc. PAST MEDICAL HISTORY -No other medical conditions in past. DRUG HISTORY FAMILY HISTORY
  • 6. SOCIAL HISTORY PERSONAL HISTORY SUBJECTIVE ASSESSMENT COUGH : Productive DYSPNOEA : Present Grade-2(NYHA scale) SPUTUM : Purulent HAEMOPTYSIS : Present
  • 7. CHEST PAIN : Present, Pleuritic Assessment : VAS scale WHEEZE : Present OTHER SYMPTOMS : Fever, Wt. loss, Fatigue and weakness.
  • 8. OBJECTIVE ASSESSMENT GENERAL OBSERVATION - Patient seems to be breathless. LEVEL OF CONSCIOUSNESS - GCS scale BODY BUILT OBSERVATION OF CHEST CHEST SHAPE :- Normal / depressed on affected side CHEST MOVEMENT :- Diminished BREATHING PATTERN :- According to gender TYPE OF BREATHING :- Tachypnoea
  • 9. ON EXAMINATION (VITALS) TEMPERATURE :- Normal RESPI. RATE :- Tachypnea HEART RATE :- BLOOD PRESSURE :- ON PALPATION TRACHEA : Normal/Central TENDERNESS : Absent TVF : Reduced CHEST EXPANSION : Diminished on affected side
  • 10. ON PERCUSSION - Dull note on percussion. ON AUSCULTATION BREATH SOUNDS : Bronchial FOREIGN SOUNDS : Crackles INVESTIGATIONS
  • 11.  CBC  Sputum examination  X-ray chest  Thoracoscopy DIAGNOSIS : Pleural effusion PT MGMT - SEE ‘PULMONARY DISEASE PT MGMT’ presentation.