Pleural Fluid Analysis
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Thoracentesis fluid analysis.
To assess and categorize fluid obtained from within the pleural space for infection, cancer, and blood as well as identify the cause of its accumulation.
There are no food, fluid, or activity restrictions unless by medical direction. Regarding the patient's risk for bleeding, the patient should be instructed to avoid taking natural products and medications with known anticoagulant, antiplatelet, or thrombolytic properties or to reduce dosage, as ordered, prior to the procedure. Number of days to withhold medication is dependent on the type of anticoagulant. Note the last time and dose of medication taken.
Method: Spectrophotometry for amylase, cholesterol, glucose, lactate dehydrogenase (LDH), protein, and triglycerides; ion-selective electrode for pH; automated or manual cell count; macroscopic and microscopic examination of cultured microorganisms; microscopic examination of specimen for microbiology and cytology.
|Amylase||Parallels serum values|
|Cholesterol||Parallels serum values|
|CEA||Parallels serum values|
|Glucose||Parallels serum values|
|LDH||Less than 2/3 the upper limit of normal serum LDH|
|Fluid LDH–to–serum LDH ratio||0.6 or less|
|Fluid protein–to–serum protein ratio||0.5 or less|
|Triglycerides||Parallel serum values|
|RBC count||None seen|
|WBC count||Less than 1,000 cells/microL|
|Gram stain||No organisms seen|
|Cytology||No abnormal cells seen|
|CEA = carcinoembryonic antigen; LDH = lactate dehydrogenase; RBC = red blood cell; WBC = white blood cell.|
Critical Findings and Potential Interventions
- Positive culture findings in any sterile body fluid.
Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.