[MeAndrawl]

I am working on a Care Plan for school and I cannot come up with Nursing Diagnosis for a pt with bilateral pleural effusions. Any suggestions?

[nicuRN2007]

I'd say impaired gas exchange.

[GingerSue]

related to collection of excess fluid in the intrapleural space with compression of overlying lung tissue
(depending on which one: empyemic, hemothorax, exudative, transudative, or chylothorax)

any infection?
any pain?
any anxiety?

[MeAndrawl]

No pain, infection or anxiety. It is a transudative effusion. The problem is that I need about 3 Nursing diagnoses. Thanks for the suggestions.

[sirI]

Hello, Meandrawl,

I moved your thread to the Nursing Student Assistance forum where you will receive more responses.

allnurses.com is the best place to come for assistance.

[nicuRN2007]

Well, I'd definitely say impaired gas exchange related to accumulation of excess fluid in the pleural space.

Is the patient SOB, tachypnic, coughing, or using accessory muscles? If so, Ineffective breathing pattern related to decreased lung compliance may be an option.

Patients with impaired gas exchange are often anxious, so anxiety could be an option.

(Risk for) Activity intolerance?
Deficient knowledge?
Risk for infection (does patient have IV's. Foley Cath)?

[nicuRN2007]

Are the transudative effusions a result of congestive heart failure?

If so you might could use decreased cardiac output or excess fluid volume.

[Daytonite]

Like medical diagnoses, the determination of nursing diagnoses is based upon the symptoms that the patient is having. So, what are your patient's symptoms? In general, a patient with pleural effusions will have:

• dyspnea
• pleuritic chest pain
• fever
• fatigue

From that you can probably use one or some of these nursing diagnoses:

• Ineffective Breathing Pattern
• Ineffective Airway Clearance
• Impaired Gas Exchange
• Hyperthermia
• Acute Pain
• Fatigue

It is important that you understand that nursing diagnoses, like medical diagnoses, also have signs and symptoms associated with each of them. If you have a care plan or nursing diagnosis book you will see that the symptoms of dyspnea is included as a symptoms of Ineffective Breathing Pattern, Ineffective Airway Clearance and Impaired Gas Exchange. You must also look at other symptoms your patient had as well that will fit with one or more of these diagnoses in order to make a proper diagnosis assignment.