Pleural Effusion

Pleural effusion is an abnormal accumulation of fluid in the pleural space. As fluid collects, it can compress adjacent lung and create a barrier between the lung and chest wall. That barrier changes physical-examination findings: air movement may sound quieter, percussion becomes dull, and vocal vibrations are transmitted less effectively through the chest wall. Positioning affects what the nurse can hear. Sitting the client upright with the torso slightly forward and the arms supported exposes the lower lung fields and helps the client breathe more comfortably. A client who is struggling to breathe is not a routine auscultation exercise; support of oxygenation and ventilation takes priority over completing the examination.