NURSING CARE

OF
THORACENTESIS

by: Nora alnaim 411230512

Nora alubaid 411230553

instructor: ms. Rehab

OBJECTIVE OF
PRESENTATION
-Definition of the procedure

-Purpose of the procedure

-Nursing care pre procedure

-Nursing care during procedure

-Nursing care post procedure

-Complication and risks of the procedure

-Nursing responsibilities

-Conclusion

-References
DEFINITION OF
THE PROCEDURE
Thoracentesis is a procedure that
removes fluid that has accumulated
abnormally in the pleural space
(pleural effusion).
PURPOSE OF THE
PROCEDURE
Thoracentesis is performed for one of two
reasons: to get a sample of fluid for a
diagnostic test or to alleviate shortness of
breath caused by fluid pressure on lung
tissue.
 Nursing care before the procedure

1- Check the doctor’s order.

2- Identify the client.
3- Explain and emphasize the importance of the procedure.
4- Inform that she will be experiencing mild pain on the site where the needle was pricked
5- Inform the client not to cough while the needle is inserted in order to avoid puncturing the lung
6- Explain when and where the procedure will occur and who will be present.
7- Explain the procedure to the patient
8- have a CT scan, performed prior to the procedure to assist the physician in identifying the specific location of the fluid in
the chest that is to be removed.
9- Ask the patient to remove any clothing, jewelry, or other objects that may interfere with the procedure.
10- The area around the puncture site may be shaved.
11- Vital signs (heart rate, blood pressure, breathing rate, and oxygen level) are to be monitored before the procedure.
 Nursing care during the procedure

1-Support the client verbally and describe the steps of the procedure as needed.
2- Vital signs (heart rate, blood pressure, breathing rate, and oxygen level) are to be monitored
during the procedure.
3-The patient may receive supplemental oxygen as needed, through a face mask or nasal cannula
(tube).
4- Observe the client for signs of distress, such as dyspnea, pallor, and coughing
5- Place the patient in a sitting position with arms raised and resting on an overbed table.
6- The skin at the puncture site will be cleansed with an antiseptic solution.
7-The patient will receive a local anesthetic at the site where the thoracentesis is to be performed.
8-Don’t remove more than 1000 ml of fluid from the pleural cavity within first 30 minutes.
9-Place a small sterile dressing over the site of the puncture.
 Nursing care after th procedure

1-Observe changes in the client’s cough, sputum, respiratory depth, and breath sounds, and note
complaints of chest pain
2-Position the client appropriately
3-Some agency protocols recommend that the client lie on the unaffected side with the head of the bed
elevated 30 degrees for at least 30 minutes because this position facilitates expansion of the affected lung
and eases respirations
4-Position the patient in a side-lying position with the unaffected side down for an hour or longer.
5-Include date and time performed; the primary care provider’s name; the amount, color, and clarity of fluid
drained; and nursing assessments and interventions provided.
6-Transport the specimens to the laboratory.
7-The dressing over the puncture site will be monitored for bleeding or other drainage.
8-Monitor patient’s blood pressure, pulse, and breathing until are stable.
9-Document all relevant information.

WHAT ARE THE RISKS

OF THORACENTESIS ?
All procedures have some risks
The risks of this procedure may include:

1-Air in the space between the lung covering (pleural space) that
causes the lung to collapse (pneumothorax)
2-Bleeding
3-Infection
4-Liver or spleen injury (rare)

Thoracentesis should not be done in people with certain bleeding conditions

WHAT TO EXPECT DURING
THORACENTESIS ?
WHAT TO EXPECT DURING
THORACENTESIS ?
A VIDEO ON THORACENTESIS

HTTPS://YOUTU.BE/
QUBAJAH_THC
NURSING RESPOSIBILITIES
Inform the patient that he must remain completely
still throughout the process. Throughout the
procedure, keep an eye on him. Keep an eye out
for indicators of a pneumothorax, such as
dyspnea, tachycardia, or chest pain, as well as
additional problems. After the needle or catheter
has been removed, cover the puncture site with a
tiny sterile dressing.
conclusion
In conclusion, thoracentesis is a
safe diagnostic technique for

neutropenic patients with
febrile
pulmonary effusions of
suspected infectious etiology,
while other invasive testing may
be required.
 ANY QUISTIONS?

 References:

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjDld-
5uazzAhVKCuwKHeJbCqcQFnoECB0QAQ&url=http%3A%2F%2Fwps.prenhall.com%2Fwps%2Fmedia%2Fobjects%
2F737%2F755395%2Fthoracentesis.pdf&usg=AOvVaw0yb5StLW8PSeIlMbHFOeIQ

https://pubmed.ncbi.nlm.nih.gov/8645835/