Thoracentesis
A procedure to remove fluid or air from the pleural space
Definition
Thoracentesis is a bedside procedure in which a needle or catheter is inserted through the chest wall into the pleural space to remove fluid (pleural effusion) or air for diagnostic or therapeutic purposes.
Pre-Procedure Nursing Care
- Informed consent
- Baseline vital signs and oxygen saturation
- Chest x-ray to confirm effusion
- Assess coagulation status
- Position patient upright leaning over a bedside table (orthopnic position)
- Instruct patient not to cough, move, or take deep breath during needle insertion
Post-Procedure Nursing Care
- Monitor vital signs, respiratory status, oxygen saturation
- Chest x-ray to rule out pneumothorax
- Assess puncture site for bleeding or drainage
- Observe for complications: pneumothorax, re-expansion pulmonary edema (with greater than 1500 mL removed), bleeding, infection
- Position on affected side (sometimes) or sitting upright
NCLEX Relevance
Upright leaning forward position. Post-procedure CXR.