# Pleural Effusion --- **Pleural effusion** is an excess of fluid in the [[pleura|pleural space]] surrounding the lungs. Normally there is a small amount (a few mL) of serous fluid in between the visceral and parietal membranes of the pleura, which allows the lungs to effectively expand and contract. ## Causes It's often caused by conditions such as [[tuberculosis|TB]], [[pneumonia]], or [[heart failure]]. ## Signs & Symptoms Signs and symptoms of pleural effusion can be absent or minimial, but sometimes there is decreased or absent [[lung sounds|breath sounds]] or a dull sort of sound. In large plural effusion (i.e. 200+ mL) there can be: - dyspnea - respiratory distress ## Diagnostic Tests - CXR - most likely this is the first thing done - chest CT - [[thoracentesis]]/fluid analysis - they go in with a big needle to extract the fluid...not fun ## Treatment The treatment of pleural effusion is largely to treat the underlying cause, but drains can be inserted of there is a lot of fluid. - [[thoracentesis]] - [[chest tube]] - pleurX kind of looks like a [[surgical drain|Jackson-Pratt]] drain that a patient can go home with. **Pleurodesis** is a procedure for severe or reoccuring pleural effusion. It essentially cements up the pleura by inserting talc there so there is no where for the fluid to accumulate. Although it is effective it also stops the pleura from doing it's job so it is quite uncomfortable and irreversable. ## Nursing Considerations - Monitor for: - complications/worsening symptoms - Educate and prepare patient - especially with home care - Ensure proper positioning - [[chest tube]] care - monitor volume ___