Overview
Pleural effusion is pathological accumulation of fluid in the pleural space — normally <20 mL — compressing lung parenchyma and impairing gas exchange.
Pleural effusion is pathological accumulation of fluid in the pleural space — normally <20 mL — compressing lung parenchyma and impairing gas exchange. Transudative effusions arise from hydrostatic/oncotic imbalance (heart failure, cirrhosis, nephrotic syndrome); exudative effusions arise from pleural inflammation, infection, or malignancy (Light's criteria distinguish them). Untreated massive effusion causes mediastinal shift, tension physiology, and respiratory failure. Chest tubes drain the effusion, restore negative intrapleural pressure, and allow lung re-expansion. Top 3 nursing priorities: (1) Maintain chest tube system patency and water-seal integrity; (2) Monitor respiratory status and oxygen saturation continuously; (3) Detect tension pneumothorax from tube malposition or clamping. Common NCLEX trap: Students clamp a chest tube when the drainage chamber cracks — WRONG. Replace the drainage system immediately; clamping risks tension pneumothorax. The only time a chest tube is clamped is during a brief system change or to locate an air leak — never routinely. On the exam, writers often pair stable-sounding options with unstable data—notice the mismatch before you commit. If the stem names a license or role, reread that line; scope errors are classic trap...
