Thoracentesis Week 12-2 Essay

Thoracentesis Week 12-2 Essay

Thoracentesis Week 12-2 Essay
Week 12-2: Thoracentesis
Thoracentesis is a surgical procedure performed to remove excess fluid accumulated in the thoracic cavity. It is performed for therapeutic and diagnostic purposes. The thoracic cavity contains trace fluid that provides lubrication between the musculoskeletal structures and lung parenchyma during the expansion and contraction of the lungs (Sperandeo et al., 2022). Excessive fluid accumulation in the space is pathological, requiring its removal through thoracentesis.

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Thoracentesis is indicated in patients with confirmed excessive fluid in the thoracic cavity or pleural space. This includes patients diagnosed with pleural effusions with symptoms like dyspnea. It is also indicated for patients with effusions associated with known causes like CHF (Ahmad, 2022). Therapeutic thoracentesis is performed in patients with large pleural effusions to relieve symptoms. It is also performed in patients with malignancies associated with pleural effusion.
No lab tests are required before the procedure. The actual site for the thoracentesis is determined through a chest X-ray, which shows the volume and location of the effusion. After thoracentesis, a chest x-ray is also performed to rule out possible pneumothorax and mediastinal shifts (Sperandeo et al., 2022). The aspirated pleural fluid is labeled and sent for diagnostic analysis. Lab tests requested from the aspirated pleural fluid include: pH level; Gram stain, culture; Blood cell count and differential; Glucose level, protein levels, and lactic acid dehydrogenase level; Cytology; Creatinine level if urinothorax is suspected; Amylase level if esophageal perforation or pancreatitis is suspected; Triglyceride levels if chylothorax is suspected (Ahmad, 2022).
Exudative pleural fluid is distinguished from transudative pleural fluid by identifying at least one of the following characteristics: Fluid/serum LDH ratio ≥0.6; Fluid/serum protein ratio ≥0.5; Fluid LDH level within the upper two-thirds of the normal serum LDH level (Ahmad, 2022). 
References
Ahmad, S. (2022). Thoracocentesis. In Procedures and Protocols in the Neurocritical Care Unit (pp. 103-112). Cham: Springer International Publishing.
Sperandeo, M., Quarato, C. M. I., Squatrito, R., Fuso, P., Dimitri, L., Simeone, A., … & Lacedonia, D. (2022). Effectiveness and safety of real-time transthoracic ultrasound-guided thoracentesis. Diagnostics, 12(3), 725. https://doi.org/10.3390/diagnostics12030725

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Define and summarize one of the following. Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

Pulmonary function tests, including discussion of how tests are ordered, why specific tests are ordered, and how the test results are interpreted.

Thoracentesis, including discussion of the indications, lab tests needed prior to the procedure, and lab tests that can be ordered based on the resulting pleural fluid.

Explain exudative versus transudative fluid with respect to pleural fluid.

Describe a VATS procedure.

Explain what atypical pneumonias are and how they are treated.

Explain “amiodarone lung.”

Discuss various sources that may serve as etiologies for asbestos exposure. Keep in mind that many patients are elderly, and some of their exposures no longer exist as a result of OSHA but can still create lung disease.

Explain what chemical, pharmaceutical, or environmental exposures can be harmful to the pulmonary system historically and currently.

Differentiate hemothorax and pneumothorax (including spontaneous and traumatic).

Explain pneumonitis: how it occurs, presents, including imaging findings, and is treated.

Explain how COPD can result in a pneumothorax.

Discuss indications for bronchoscopy and how the patient must be prepared for this procedure, including coagulation studies, readiness for sedation, and airway invasion.

Explain the process of liberating a patient from a ventilator.

Explain at what point a ventilator patient must be converted from an endotracheal tube to a tracheostomy tube.

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