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Pleurisy

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VOL: 101, ISSUE: 10, PAGE NO: 28

What is it?

- Pleurisy, also known as pleuritis, is inflammation of the pleura, the double-layered membrane covering the lungs.

- One layer of the pleura is attached to the lung surface and the other to the chest wall. The two layers are separated by a thin layer of lubricating fluid in the pleural space, enabling them to move over each other smoothly.

- Pleurisy causes roughening of the surfaces of the pleura.

- Pleurisy is a symptom rather than a disease.

Risk factors

- Advanced age.

- Smoking.

- Chronic lung diseases:

- Asthma;

- Bronchitis;

- Cystic fibrosis.

- Heart failure.

- Diabetes.

- Cancer.

- Immobility.

Causes

- Pneumonia.

- Tuberculosis.

- Chest trauma.

- Pulmonary infarctions.

- Neoplasms.

Symptoms

- Sharp, stabbing pain caused by the pleura rubbing against one another.

- Viral pleurisy does not usually cause serious debilitation, although pleuritic pain can be severe.

- Pain usually occurs when inhaling, coughing or twisting the body, often at the end of a deep breath, and can occur anywhere in the chest.

- Cough, cold, flu-like symptoms.

- Fever and general discomfort.

- Rapid, shallow respiration.

- Diminished breath sounds.

Nursing care

- Assess respiratory function.

- Administer analgesic.

- Teach patient to support ribcage when coughing.

- Help reposition to alleviate pain, such as lying on the affected side.

- Assess level of anxiety and provide reassurances of safety.

Diagnosis

- Based on symptoms and hearing a pleural rub with a stethoscope.

- Chest X-ray often reveals the underlying cause of the pleurisy.

- Blood tests and sputum analysis may be necessary, particularly if the condition is severe or does not respond to treatment.

Complications

- Pleural effusion (excessive pleural fluid, which forces the pleura apart and collects in the lower parts).

- The effusion may compress and partially collapse the lung.

- Pleural adhesion (inflamed patches of the pleura become permanently stuck together).

Treatment

- Treatment tackles the underlying cause, as there is no specific treatment for pleurisy itself.

- Viral pleurisy is usually resolved without treatment, although analgesia may be necessary.

- Anti-inflammatory drugs may ease symptoms.

- If the condition is severe, particularly if it is accompanied by pneumonia, oxygen may be required.

- Symptoms should subside within 7-10 days.

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