NR 293 Respiratory Pleural Effusion and RestrictiveLung Disease Case Study
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,A.B., a 68-year-old man, is admitted to your medical floor with a
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diagnosis of pleural effusion. He complains of shortness of breath;
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pain in his chest; weakness; and a dry, irritating cough. His vital
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signs (VS) are 142/82, 118, respirations 38 and laboredand
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shallow, 102.1° F (38.9° C), and Spo2 85% on room air.
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Chest x-ray examination reveals a large pleural effusion and
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pulmonary infiltrates in the right lower lobe consistent with
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pneumonia.
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1. Given his diagnosis, are A.B.'s admission VS
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expected?Explain I
YES, because he is in pain which can cause significant
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increase in heart rate and blood pressure.
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Respirations are labored and shallow because of thepain I I I I I I I I
of inspiration. Also, his oxygen is low because shallow
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breathing does not necessarily provide adequate
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oxygenation. In addition, there can be empyema (pus in
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the pleural space which usually develops after
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pneumonia is an infection of the lung
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tissue)withfever. I I
, How does the underlying pathophysiology
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relate to A.B.'s presenting signs and
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symptoms?
I
2. The underlying pathophysiology of a pleural effusion
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gives rise to A.B’s symptoms because fluid in the pleural
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cavity acts as a small-occupying mass thatcauses
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decrease in lung expansion on the affected side. The
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patient’s symptoms are shortness of breath (SOB) and
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labored and shallow respirations at 38 bpmdue to fluid
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collection in the pleural cavity. The lungs are trying to
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compensate from the lack of oxygen in the alveoli from
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the fluid so the patient will breathe faster, possibly
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increase in body temperature, have weakness and be
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short of breath
I I I
I I I I I I I I I I
,A.B., a 68-year-old man, is admitted to your medical floor with a
I I I I I I I I I I I
diagnosis of pleural effusion. He complains of shortness of breath;
I I I I I I I I I I
pain in his chest; weakness; and a dry, irritating cough. His vital
I I I I I I I I I I I I
signs (VS) are 142/82, 118, respirations 38 and laboredand
I I I I I I I I I I
shallow, 102.1° F (38.9° C), and Spo2 85% on room air.
I I I I I I I I I I I
Chest x-ray examination reveals a large pleural effusion and
I I I I I I I I
pulmonary infiltrates in the right lower lobe consistent with
I I I I I I I I I
pneumonia.
I
1. Given his diagnosis, are A.B.'s admission VS
I I I I I I
expected?Explain I
YES, because he is in pain which can cause significant
I I I I I I I I I
increase in heart rate and blood pressure.
I I I I I I I
Respirations are labored and shallow because of thepain I I I I I I I I
of inspiration. Also, his oxygen is low because shallow
I I I I I I I I I
breathing does not necessarily provide adequate
I I I I I I
oxygenation. In addition, there can be empyema (pus in
I I I I I I I I I
the pleural space which usually develops after
I I I I I I I
pneumonia is an infection of the lung
I I I I I I I
tissue)withfever. I I
, How does the underlying pathophysiology
I I I I
relate to A.B.'s presenting signs and
I I I I I I
symptoms?
I
2. The underlying pathophysiology of a pleural effusion
I I I I I I
gives rise to A.B’s symptoms because fluid in the pleural
I I I I I I I I I I
cavity acts as a small-occupying mass thatcauses
I I I I I I I I
decrease in lung expansion on the affected side. The
I I I I I I I I I
patient’s symptoms are shortness of breath (SOB) and
I I I I I I I I
labored and shallow respirations at 38 bpmdue to fluid
I I I I I I I I I I
collection in the pleural cavity. The lungs are trying to
I I I I I I I I I I
compensate from the lack of oxygen in the alveoli from
I I I I I I I I I I
the fluid so the patient will breathe faster, possibly
I I I I I I I I I
increase in body temperature, have weakness and be
I I I I I I I I
short of breath
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