Pleural Effusion

2. Diagnosis: Pleural effusion

3. Condition:

4. Vital signs: q shift. Call physician if BP >160/90, <90/60; P>120, <50; R>25, <10; T >38.5 °C

5. Activity:

6. Diet: Regular.

7. IV Fluids: D5W at TKO

8. Extras: CXR PA and LAT, repeat after thoracentesis; left and right lateral de-cubitus x-rays, ECG, ultrasound, PPD; pulmonary consult.

9. Labs: CBC, SMA7&12, protein, albumin, amylase, ANA, ESR, INR/PTT, UA. Cryptococcal antigen, histoplasma antigen, fungal culture.

Thoracentesis:

Tube 1: LDH, protein, amylase, triglyceride, glucose (10 mL). Tube 2: Gram stain, C&S, AFB, fungal C&S (20-60 mL, heparinized). Tube 3: Cell count and differential (5-10 mL, EDTA). Syringe: pH (2 mL collected anaerobically, heparinized on ice) Bag or Bottle: Cytology.

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