RUFAIDA COLLEGE OF NURSING
JAMIA HAMDARD
ASSIGNMENT ON THORACENTESIS
SUBMITTED TO SUBMITTED BY
MS. FAREHA KHAN MS. SAFIYA ANSARI
ASSISTANT PROFESSOR MSC. NURSING 1ST YEAR
SUBMITTED ON- 17th FEBRUARY, 2023
THORACENTESIS
DEFINITION
Thoracentesis is a procedure to remove fluid from the space between the lungs and the
chest wall called the pleural space.
or
Thoracentesis is a procedure that removes an abnormal accumulation of fluid or air from the
chest through a needle or tube.
PURPOSE
To determine the cause of abnormal accumulation of fluid in the pleural space.
Relieve shortness of breath and pain
As a diagnostic or treatment procedure
To drain large amounts of pleural fluid
To equalize pressure on both sides of the thoracic cavity
INDICATION
Traumatic pneumothorax
Hemopneumothorax
Spontaneous pneumothorax
Bronchopleural fistula
Pleural effusion
CONTRAINDICATION
An uncooperative patient
Coagulation disorder
Atelectasis
Only one functioning lung
Emphysema (pulmonary enlargement)
Severe cough or hiccups
COMPLICATION
Pulmonary edema
Respiratory distress
Air embolism
Cardiac tamponade (fluid build up in the space between myocardium and
pericardium)
Bleeding
Infection
Dyspnea and cough
Atelectasis (lung collapse)
BEFORE THE PROCEDURE
Explain the purpose, risks/benefits, and steps of the procedure and obtain consent
from the patient or appropriate legal design.
Take Medical History
PREPARE EQUIPMENT
Dressing set
Abraham’s needle
Connecting tubing
Syringe 50ml and 5ml
Scapel blade and blade 11
Needles (18 and 23 gauge)
Sterile Glove
Mask
Povidone / Alcohol
Local anaesthetic, e.g. lignocaine (lidocaine) 1% or 2%
Formalin bottle
Urine bottle x2
C+S bottle
3-way stopcock
Fenestrated towel
BEFORE THE PROCEDURE
Check platelet count and/or presence of coagulopathy. If platelet count is < 20,000, or
there is known coagulopathy as to whether platelet transfusion or other intervention is
needed
R: To prevent complication such as bleeding while during procedure.
Place patient upright / cardiac position and help patient maintain position during
procedure.
R: the upright position ensures that the diaphragm is more dependent and facilitates
the removal of fluid that usually localizes at the base of the chest.
Explain that he/she will receive a local anesthetic
R: to minimize pain during the procedure.
Clean patient skin with antiseptic soap
R: To prevent infection and maintain aseptic technique.
DURING PROCEDURE
Observe patient respiration rate and breathing pattern.
R: to provide base line data to estimate patient tolerance of procedure
Assess patient vital sign such as B/P, pulse
R: To prevent any complication such as hypovolemic shock during procedure.
Observe patient level of consciousness and give emotional support
R: To reduce patient anxiety
Monitor saturation
R: To prevent hypoxia
Inform doctor if any changes of the patient
R: To make sure whether need to continue the procedure or stop immediately.
AFTER PROCEDURE
Obtain a chest x-ray to evaluate the fluid level.
R: To compare the conditions of the lungs before and after the procedure.
For specimen handling, fill the tubes with the required amount of pleural fluid
R: To prevent over intake of the fluid to the specimen bottle.
Check that each bottle is correctly labelled by checking patient identifiers- full name,
date of birth and/or medical record number then send to the lab tests
R: To prevent from incorrect results to the patient.
Document the procedure, patient’s response, characteristics of fluid and amount, and
patient response to follow-up.
R: To develop further treatment to the patient.
Provide post-procedural analgesics as needed.
R: To prevent patient from pain related to the incision site.
Rest in bed for about 2 hours after the procedure
R: To minimize patient activity due to complication such as dyspnea.
Blood pressure and breathing will be checked for up to a few hours
R: to make sure don't have complications
