pleural effusion

[momandstudent]

I am studying for a test and out of the practice questions, a pt. came in with pleural effusion. His vital signs were elevated: BP 142/82 HR 118 and Resp. 38 (labored and shallow). Why are vital signs elevated with pleural effusion. I tried searching through my texts and can't find anything that explains it. Can anyone explain it to me?

[driving85]

Pain. There's significant pain with a pleural effusion, which can easily cause an increase in heart rate and blood pressure. Respirations are labored and shallow because of the pain of inspiration. The patient is tachypnic because shallow breathing does not necessarily provide adequate oxygenation. To maintain appropriate oxygen levels, more breaths per minute are necessary. Additionally, there can be empyema with fever, which could also cause tachycardia.

[momandstudent]

Thank you very much for your reply. If I had thought about the pain-it would have all made sense to me. Too many times, I am trying to go to extreme with this stuff and it does nothing but cause me pain-no pun intended. I appreciate your response and after reading "pain" it clicked.

[driving85]

No problem. I used to rack my brain trying to come up with something big and impressive sounding and miss the obvious staring me in the face. Glad I could help. :)

[leslie :-D]

I am studying for a test and out of the practice questions, a pt. came in with pleural effusion. His vital signs were elevated: BP 142/82 HR 118 and Resp. 38 (labored and shallow). Why are vital signs elevated with pleural effusion. I tried searching through my texts and can't find anything that explains it. Can anyone explain it to me?

not all pleural effusions present w/increased vs's or even pain.

only through thoracentesis, can cause and effect be determined.

but it's usually r/t either chf or lung disease.

depending on how much fluid/exudate is confined within the pleural sac, there is going to be restrictive expansion of lungs as well as diaphragm.

this alone would create a backup of pressure, causing htn.

increased resps are a compensatory mechanism r/t inadequate gas exchange:

and tachycardia could be r/t an inflammatory process and/or extra work of the cardiopulmonary system.

but once you know the definitive etio of the effusion, s/s are readily explained in most cases.

leslie

[EmGee]

Hey, are you from NYU? We have the same case study you've just mentioned...hmmm....

[momandstudent]

No, from good 'ol Minnesota.