Thoracentesis

WHAT YOU SHOULD KNOW

Risks

IF YOU'RE HEADING FOR THE HOSPITAL...

Before You Go

• The Week Before the Procedure:
• You'll probably need to stop taking aspirin and ibuprofen; the doctor will tell you when. If you're taking aspirin for your heart, don't stop without asking the doctor first. Also ask whether you can take any over-the-counter medicines.
• Your doctor will tell you whether you need to have blood drawn.
• The Night Before the Procedure:
• Your physician may suggest you take a sleeping pill.
• Just before surgery, you should not eat or drink anything (even water). Your doctor will tell you when to begin fasting.

When You Arrive

• Check with your doctor before taking insulin, diabetes pills, blood pressure medicine, heart pills, or any other medication on the day of surgery.
• Do not wear contact lenses to the hospital. You may wear glasses.

What to Expect While You're There

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Blood Tests: You may need blood taken for tests. It can be drawn from a vein in your hand or from the bend in your elbow. Several samples may be needed.
• Chest X-ray: The doctor will check this picture of your lungs and heart to make certain they can handle the procedure.
• Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• Pulse Oximeter: With a little clip connected to your ear, finger, or toe, this machine measures the oxygen in your blood.
• Local Anesthesia: You'll be given a pain-numbing shot in the chest to make you comfortable during the procedure. You may still feel pressure or pushing as the needle is inserted.

After the Procedure:

• Chest Tubes: These tubes, inserted in your chest during the thoracentesis, will remove air, blood, or fluid from the area around your lungs. This will allow your lungs to refill with air when you breathe. The tubes will be attached to a container containing bubbling water.
• Oxygen: You may need help getting oxygen for a while after the procedure. It is given either through a plastic mask over your mouth and nose or through nasal prongs. If the oxygen dries out your nose or the nasal prongs bother you, tell your nurse, but don't take off the oxygen on your own.
• Deep Breathing and Coughing: These exercises help prevent a lung infection. Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum from your lungs and keep them clear. You should deep breathe and cough every hour while you are awake, including any time you spend awake during the night.
• Hold a pillow tightly against your abdomen to help reduce pain. Take a deep breath and hold it as long as you can. Then push the air out of your lungs with a deep strong cough. Put any sputum that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
• Incentive Spirometer (spy-ROM-uh-tur): This piece of equipment helps you take deeper breaths. Put the plastic nozzle into your mouth, take a very deep breath, and hold it as long as possible. Then blow as hard as you can into the mouthpiece.
• Breathing Treatments: You may need special treatments to help open your airways and make breathing easier. A machine may be used to help you breathe in medicine. At first you may need them more often, but as you get better, you may only need them when you are having trouble breathing.
• Activity: You may need to rest in bed for a while. But even if you are confined to bed, it's important to exercise your legs in order to stop blood clots from forming. Lift one leg off the bed and draw big circles with your toes, then repeat with the other leg. You can also try lying on your side and pretending to pedal a bike. When you're told it's OK to get out of bed, make sure someone is with you the first time you try. If you feel weak or dizzy, sit or lie down right away.
• Medicines:
• Antibiotics: These medicines help prevent bacterial infection. They may be given by IV, as a shot, or by mouth.
• Pain Medicine: To ease pain after the operation, your doctor will probably prescribe medication to be given by IV, as a shot, or by mouth. Tell the doctor or your nurses if the pain won't go away or keeps coming back.

After You Leave

• Always take your medicine exactly as directed. If it doesn't seem to help, let the doctor know, but keep taking it until told otherwise. If you've been prescribed antibiotics, be sure to use them up, even if you're feeling better. If a medicine makes you drowsy, avoid driving or using dangerous machinery.
• When you are allowed to bathe or shower, carefully wash the site of the needle insertion. Then put on a clean, new bandage. Change the bandage any time it gets wet or dirty.
• Eat healthy meals from all 5 food groups: fruits, vegetables, breads, dairy products, and meat. This will increase your energy level and promote faster healing.
• Unless instructed otherwise, drink 6 to 8 large glasses of liquid, such as water, juices, and milk, each day. Limit caffeinated beverages, such as coffee, tea, and soda.
• Slowly start to do more each day, resting as needed. Once you feel stronger, start a regular exercise program. Exercise makes the heart stronger, lowers blood pressure, and keeps you healthy. Your doctor can help you plan the program. Do not lift anything heavy until your doctor says it's OK.
• You may have sex when you feel ready.
• If you smoke, this is an excellent time to quit. Smoking increases your chance of having a heart attack, lung disease, or cancer. If you have trouble quitting, ask your doctor for help.

Call Your Doctor If...

• You have a chest tube and the area around it is swollen and red, or has pus coming from it. These are signs of infection.
• Any stitches or staples you have begin to come apart.
• Your bandage becomes soaked with blood.
• You are running a high temperature.
• You have itchy, swollen skin or develop a rash. You may be allergic to your medicine.

Seek Care Immediately If...

• You suddenly have trouble breathing, or your lips turn blue.
• The pain in your chest gets a lot worse.
• You notice blood in your sputum.