Medical Surgical Pleural Effusion & Thoracentesis #2

Question

The nurse is assisting the health care provider with a thoracentesis for a client with an empyema. The nurse will plan to have which precaution available at the bedside during the procedure?

Answers

  1. A chest tube insertion kit.
    • Rationale:

      This answer is correct because the most important precaution for a thoracenteses is the availability of a chest tube. Empyema will present with purulent type thick fluid with the needle aspiration and may require a chest tube to drain the purulent effusion.

  2. An intubation kit.
    • Rationale:

      This answer is not correct because it is highly unlikely that a client undergoing a thoracentesis will require intubation. It is most important to have a chest tube kit readily accessible in order to drain the fluid from the client’s pleural space.

  3. Standby ventilator.
    • Rationale:

      This answer is not correct because it is not likely that this client would require intubation with mechanical ventilation during a routine thoracentesis. It is the priority to have chest tube equipment available in order to drain purulent fluid from the client’s pleural space.

  4. Morphine.
    • Rationale:

      This answer is not correct because morphine is not indicated during this procedure. The client would receive medication for sedation/ pain control prior to the procedure if indicated.

Overview

The focus of this question is appropriate planning for a client scheduled for a thoracentesis. An empyema is a collection of purulent, infected fluid within the pleural space which may require aspiration with a chest tube.

Explanation

Learning Outcomes

Thoracentesis is an invasive procedure that uses needle decompression to remove fluid or air from the pleural space either diagnostically or therapeutically. Because a large bore needle is inserted directly into the pleural space, pneumothorax is one potential complication. The nurse should have a chest tube insertion kit nearby during insertion in case signs of pneumothorax are noted.

Test Taking Tip

Analyze each answer choice and look for the choice that differs from the others. In this case, 1 & 4 are different so 2 & 3 could be eliminated early on.

Video Rationale