Loculated Pleural Effusion & NCP for CTT

[ails]

Need help with loculated pleural effusion. How do you describe it? The Brunner (and some other) books describe it as being "walled-off". Sorry if I don't get what it means but it's one of the things that make it a bit harder for us foreign students when it comes to understanding the textbooks. Though we understand English, we don't usually use some common words like walled-off and others because it's not taught at school and we don't use them (currently looking for dunce smilie but can't find one ) :smackingf I've searched the net and browsed books but only a few contain it and with the definitions I get, I'm still dumbfounded :uhoh21:

About the NCP, my instructor suggested/told me that another appropriate NCP for my patient is "Altered comfort" (to closed thoracostomy tube?). It's not found in the Nanda. The patient is a 5-month old baby so I can't do some distractions like magazine-reading. There're also no toys there because it's a Pulmonary CCU. Are there any other ways to provide comfort to the baby? Aside from giving pain relievers as ordered, what are the appropriate non-pharmacologic interventions I can do?

Thanks a million in advance! :)

[Daytonite, BSN, RN]

an effusion is fluid that has gathered in the tissues of the lung. loculated pleural effusion means that all this fluid is one place, not spread out all over the lung. the fluid has formed within it's own precise space. what brunner's is saying is that the effusion looks like (but isn't) a sac (pouch or vesicle) of fluid.

altered comfort is an older nursing diagnosis. it is not an official nanda nursing diagnosis. however, it is included in nursing diagnosis handbook: a guide to planning care, 7th edition, by betty j. ackley and gail b. ladwig but titled as impaired comfort. here is a link to the online webpage that has much of the information that is in the book.

[color=#3366ff]impaired comfort

there isn't anything in their actual book about pediatric interventions. the interventions are mostly to keep the patient from focusing on their illness. this diagnosis is often used with sunburns and itchy skin, fevers, and colic and chickenpox in children. since the childs response is primitive and uncontrolled, they are going to scratch at itchy skin (and make it worse), cry, pick at scabs, tear off dressings, etc. so, you want to divert their attention. keep in mind what the developmental tasks are supposed to be for a 5-month old child and design activities around helping them achieve those developmental tasks

• http://www.baptistonline.org/health/library/chil3048.asp

after you read that webpage, think about what you do when socializing with 5-month olds in your culture? children of this age like to hear different sounds and try to mimic them. there's something you can make a simple game of right there. they like to cling. so, a soft stuffed toy might be appropriate to get the child interested in. perhaps a stuffed doll or animal who also has the same kind of dressings, hospital cloths or a little trach tube tied to it would work, but i'm thinking that might be a little too advanced for a 5-momth old. read the webpage link.