The nurse is preparing a patient for a thoracentesis to drain an ...

[Awilson837]

The nurse is preparing a patient for a thoracentesis to drain an empyema. What should the nurse instruct the patient about this procedure?
 
  Select all that apply.
 
  1. You will have a chest x-ray after the procedure.
  2. You will lie on the unaffected side for 1 hour after the procedure.
  3. You will have general anesthesia for pain control during the procedure.
  4. You will be seated, learning forward with arms and head supported with an overbed table.
  5. You will be permitted to resume normal activities after 1 hour if no evidence of adverse effects occurs.

Question 2

The nurse is preparing to assess a patient admitted for treatment of bilateral pleural effusions. On what should the nurse focus when assessing this patient?
 
  Select all that apply.
 
  1. Urine output
  2. Cardiac rate and rhythm
  3. Joint function and mobility
  4. Muscle tone and movement
  5. Peripheral pulses and edema

[batool]

Answer to Question 1

Correct Answer: 1, 2, 4, 5
The patient will be positioned upright for the procedure, leaning forward with arms and head supported on an anchored overbed table. This position spreads the ribs, enlarging the intercostal space for needle insertion. After the procedure a chest x-ray is ordered to detect possible pneumothorax. The patient will be positioned on the unaffected side for 1 hour. This allows the pleural puncture to heal. Normal activities generally can be resumed after 1 hour if no evidence of pneumothorax or other complication is present. The puncture wound of thoracentesis heals rapidly. Only local anesthesia is used in this procedure.

Answer to Question 2

Correct Answer: 1, 2, 3, 5
Excess pleural fluid may be either transudate, formed when capillary pressure is high or plasma proteins are low, or exudate, the result of increased capillary permeability. Heart failure is the most common precipitating factor in transudate formation; it also may accompany renal failure and an inflammatory process such a systemic inflammation associated with rheumatoid arthritis. The nurse should focus on the patient's urine output, cardiac status, peripheral pulses, edema, and joint mobility and function. Muscle tone is not affected by pleural effusion.

[Awilson837]

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[Perkypinki]

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