thoracentesis diagnostic procedure ati thoracentesis diagnostic procedure ati

This space is between the outside surface of the lungs (pleura) and the chest wall. At home, you can go back to your normal diet and activities if instructed -monitor for manifestations of pneumothorax -bleeding Become a Member; COVID-19; COURSES. Adpirated fluid is analyzed for general Therapeutic thoracentesis is indicated to relieve the symp- toms (e.g., dyspnea, cough, hypoxemia, or chest pain) Your healthcare provider may have other reasons to advise thoracentesis. StatPearls. Patient-centered outcomes following thoracentesis. The practitioner can then slide the needle between two of your ribs, guiding it into the pleural space. It is a very helpful diagnostic procedure to help give you the answers you are looking for. *Pneumonia This is the nursing care plan for the bronchoscopy procedure. Although thoracentesis is generally considered safe, procedural complications are associated with increased morbidity, mortality, and healthcare costs. Contraindications. Thoracentesis is also known by the term . Is chest radiography routinely needed after thoracentesis? Add to cart. bacterial peritonitis. location of the fluid to be removed. Thoracentesis helps determine the cause of the excess fluid. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. If there is any doubt, pleural fluid should be sent for diagnostic analysis (see below); in practice, diagnostic analysis is almost always necessary. Shortness of breath. (diminished breath sound, distended neck veins, For example, it is likely you will need thoracentesis if you have a new pleural effusion and if the medical reason for it is not clear. 2005. How to prepare for a thoracentesis: There are many indications for thoracentesis that can generally be categorized under one of two headings: Diagnostic: Evaluation of pleural fluid to diagnose primary disease process. bandage or dressing will be put on the area. Someone will clean the skin around the area where the needle is to be inserted. Access puncture site dressing for drainageWeight the pt. Cavanna L, Mordenti P, Bert R, et al. Cleanse the skin with chlorhexidene. Wiederhold BD, Amr O, O'Rourke MC. Diagnostic thoracentesis Indicated for almost all patients who have pleural fluid that is new or of uncertain etiology and is 10 mm in thickness on computed tomography (CT) scan, ultrasonography, or lateral decubitus x-ray (see figure Diagnosis of Pleural Effusion ) Wheezing is a narrowing of the airways and indicates that the medication has not been effective. That Theyll be in good company. Diagnostic analysis of pleural effusion: 1) Any new pleural effusion, except in the case of clinically suspected transudate due to heart failure, hypoalbuminemia, cirrhosis, end-stage renal failure, or in patients with small effusions; in such circumstances treat the underlying cause, reassess, and consider thoracentesis if effusion does not resolve with A thoracentesis is a relatively simple procedure that involves using a needle to remove fluid from the pleural space. Diagnostic Criteria: Anorexia Nervosa. Find more COVID-19 testing locations on Maryland.gov. A renal biopsy is used to obtain a segment of renal tissue, usually through a needle or another surgical instrument. A success rate of up to 90% has been . Course Hero is not sponsored or endorsed by any college or university. Youll breathe easier afterward. Current Diagnosis & Treatment in Pulmonary Medicine. The Please be aware that we do not give advice on your individual medical condition, if you want advice please see your treating physician. Ultrasound allows the distinction between effusion and lung consolidations, and the diagnostic accuracy of ultrasound for pleural effusions is superior (93%), compared to auscultation (61%) and AP chest radiograph (47%), using chest CT as the reference standard. - treating postoperative atelectasis. breath at certain times during the procedure. : an American History, CWV-101 T3 Consequences of the Fall Contemporary Response Worksheet 100%, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1. Therapeutic intervention in a symptomatic patient. (sVW;5P5ePDC/4;QG$:}EG!aN'9bY,;-lCjJF=\4?4Y"{s>hJYyyV\$"u+> After the procedure, another chest x-ray may be needed to check for the presence of a pneumothorax (see complications below). D3VD@d\s&Ekddrx Fluid analysis is fundamental and guides further diagnostic and therapeutic decisions. STUDENT NAME______________________________________ You may be asked to sign a consent form that gives I do not give the patient any medication before to the Thoracentesis. Thoracentesis is performed under local anesthesia by a provider at the clients bedside, Your healthcare provider may give you other instructions after the Deliver up-to-date nursing information to every student and faculty member. If you cant sit, you can lay on your side instead. A thoracentesis allows your lungs to expand fully so you can breathe more easily. Depending on the situation, it may be performed in a hospital or at a practitioners office. During the Procedure. stream from rubbing together when you breathe. Before the thoracentesis, your healthcare provider will talk to you about all your medical conditions, perform a physical exam, and assess your health. The inside of the chest is also lined with pleura. Thoracentesis removes some of the excess fluid surrounding the lungs when there is a pleural effusion. Your arms will Blood culture bottles 4. distended neck veins, asymmetry of the anything is not clear. Someone may also mark the appropriate side for the needle insertion. You may get an infection in your wound, or in the lining of your abdomen. falls due to hypovolemia, Pre-procedureExplain procedure, obtain consent form Over 1.5 million people a year in the U.S. experience such a pleural effusion.. procedures, such as lung or cardiac surgery. Risk factors for post-LP headache: Patient factors: young age - history of headaches; Procedure factors: sitting position - large needle - cutting needle - multiple attempts gown to wear during the procedure. Because some of the problems causing pleural effusions are quite serious, its important that healthcare professionals perform thoracentesis to help pinpoint the problem. INTRODUCTION. Chest X ray should be taken before thoracentesis is done , to diagnose the location of the fluid in the pleural cavity 3. Pulmonary function tests determines lung function measure lung volumes capacities diffusion capacity gas exchange flow rates airway resistance identifies disease Instructions for pulmonary function tests instruct client not to smoke six to eight hours prior to testing if client uses inhalers withhold 4 to 6 hours prior to testing ABG site. The fluid will drain 1. Many are very mild and require no treatment; some may require placement of a tube thoracostomy to drain the air. That just means that your healthcare provider needs more information to determine the cause of your medical problems. Thoracocentesis: From bench to bed. Thoracentesis (thor-a-sen-tee-sis) is a procedure that is done to remove a sample of fluid from around the lung. Ask your provider how to manage any symptoms or side effects you have after the procedure, including pain, coughing or fluid leaking from the drainage site. (Select all that apply.) Parenting information is available at Parenthub.com.au, The Medical System Bulk Billing & Medicare. The procedure may be done to take a sample of the fluid for testing to help find the cause. If youre unable to sit, you can lie on your side. content, the presence of enzymes such as Pleural effusions of unknown origin and parapneumonic effusions almost invariably require thoracentesis. (Fig. No, thoracentesis isnt considered a major surgery. This is a condition in which the space between the lungs and the inside of the chest wall contains excess fluid. It can give you answers about whats causing the fluid around your lungs and relieve pressure that makes it hard to breathe. Nature of the procedure or treatment and who will perform the procedure or treatment. Thoracentesis is a procedure that a provider uses to drain extra fluid from around the lungs (pleural space) with a needle. The use of thoracic ultrasound to guide thoracentesis and related procedures will be reviewed here. monitor vital signs, measure and record amount of fluid removed from The sample of fluid that is drained from the effusion can be analysed for the presence of infectious agents such as bacteria, or for special cell types that may suggest malignancy, as well as various other factors which may provide clues to the cause. Many people have fluid on their lungs that keeps coming back because of an underlying medical condition. The lung is seen as an echogenic structure moving with respiration. You may feel some pressure where the Afterward, you could get a Alternative Names Pleural fluid aspiration; Pleural tap How the Test is Performed The test is done in the following way: You sit on a bed or on the edge of a chair or bed. It depends on your condition and your Is chest radiography routinely needed after thoracentesis? Chemotherapy administration into pleural cavity requiring thoracentesis: 764639: Education about disorders requiring anticoagulation therapy: 419137 . Your provider may tell you avoid strenuous activities for 48 hours. several hours after thoracentesis. For example, thoracentesis is not usually recommended for people with severe respiratory failure or people who dont have adequate blood pressure. A diagnostic thoracentesis may be repeated if initial results fail to yield a diagnosis. respiratory distress, cyanosis) Interpreting Results. padded bedside table with his or her arms crossed.Assist Most commonly, people have thoracentesis when they are fully awake. -pneumonia You may be given oxygen through a nasal tube or face mask. Dont hesitate to ask if you have any questions about how the procedure works or how to best interpret the results from your procedure. Thoracentesis refer to the puncture by needle through the chest wall into the pleural space for the purpose of removing pleural fluid (blood, serous fluid, pus, etc) and or air (pneumothorax) Thoracentesis or pleural . C. It is not indicated that the client needs ABGs drawn. What to expect when undergoing this test or treatment. The tests done here may take a day or more to come back. Are pregnant or think you may be pregnant, Are sensitive to or allergic to any medicines, latex, tape, or If you are having thoracentesis as an outpatient, make sure to bring your insurance card and any necessary paperwork with you. Hawatmeh A, Thawabi M, Jmeian A, et al. A high frequency linear transducer (7.5 to 12 MHz) is the optimal choice for this procedure and placed on the patients back in the sagittal or transverse position. Sudden trouble breathing or shortness of breath. by your healthcare provider, Plan to have someone drive you home from the hospital, Follow any other instructions your healthcare provider gives you. Michael Mirza, MDChristopher Bryczkowski, MD, FACEP. Your healthcare provider doesnt have to make large cuts or damage tissue (minimally invasive), so theres low risk of complications. provider with the procedure. You may feel a pinch when they put the needle in. *Exuadates (inflammatory, infectious, pleural fluid. Are you having the procedure for diagnosis, for therapy, or for both? Pleural fluid analysis is used to help diagnose the cause of accumulation of fluid in the chest cavity (pleural effusion). The risk of complications is minimized by making sure that the procedure is done only when necessary for symptom relief or to find the cause of pleural effusion. : an American History (Eric Foner), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. It causes symptoms like: Chest pain. #0l/KIJv?45.!cAO'~m&#c|H[jJAIqb!fmjjwaXkE#%*]f+/V9W*x!&EPewqdlde#G&c|/$mn,Xl%bbMHDt3jE'W: I^`WlQrJ)M2X7onk1*dG,YX~y1lr W4S2rL-U:N]F{FT-FtIRk;wjdG>@PtW92[4$4?hKcG}u~i96E U'[[_WTfGSt[PZ5%cH(Wqqi bcOxvD;mj!!cqS^;%gC #\d dfCLM Doru Paul, MD, is board-certified in internal medicine, medical oncology, and hematology. cytological examination) and/or therapeutic (where pleural fluid is removed to provide . ThZL9`S{e0k[Jo$J#L'd*$zr>&B+Yp?v`b8d^:P.L" B,OX3|`)i<. During a thoracentesis your provider will: After a thoracentesis, your provider may get another X-ray or ultrasound of your lungs. Purpose The lungs are lined on the outside with two thin layers of tissue called pleura. J Thorac Dis. This is particularly common in pleural effusions associated with malignancy. 2015;7(Suppl 1):S1S4. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Fluid in the pleural space appears anechoic and is readily detected above the brightly echogenic diaphragm when the patient is in a supine position. Some medical conditions and diseases cause fluid to leak into the pleural space (pleural effusion), which makes it hard to breathe. Procedure technique: 1. They may ask you to: Before a thoracentesis, your provider will take your blood pressure and use a small device on your finger to measure your blood oxygen level. Sockrider AM, Lareau S, Manthous C. American Thoracic Society. Lying in bed on the unaffected side. If diagnostic purpose remove less than 100 ml of fluid from the pleural cavity. <> At Another Johns Hopkins Member Hospital: Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov. Measure abdominal girth and elevate head of bedIntra-procedure Thoracentesis outcomes: a 12-year experience. In patients with adverse prognostic factors (pH < 7.20, glucose < 60 mg/dL (< 3.33 mmol/L), positive Gram stain or culture, loculations), the effusion should be completely drained via thoracentesis How To Do Thoracentesis Thoracentesis is needle aspiration of fluid from a pleural effusion. Fluid will slowly be withdrawn into the needle. Next the needle will be removed, and the area will be bandaged. Chest x-ray ; Ultrasound of the chest ; Lung biopsy; Thoracentesis ; A client with a pleural effusion would most likely present to the hospital with. into a bottle or bag. Ultrasound allows the distinction between effusion and lung consolidations, and the diagnostic accuracy of ultrasound for pleural effusions is superior (93%), compared to auscultation (61%) and AP chest radiograph (47%), using chest CT as the reference standard. wall. Ascitic fluid may be used to help, determine the etiology of ascites, as well as to evaluate for infection or presence of cancer, New-onset ascites - Fluid evaluation helps to, determine etiology, differentiate transudate, Maintain pressure at insertion site for several minutes and apply a, - Check vital signs, record weight, and measure abdominal girth, - Monitor temp every 4 hours for 48 hours, - Administer IV fluids or albumin as prescribed, - Assist patient into a comfortable position with HOB elevated to. Blood clots in your lungs (pulmonary embolism). Cleve Clin J Med. (Fig. Explain what about each item led you to choose it and what you learned from, Can you give me a case scenario of a disease PNEUMOTHORAX and what could be the possible nursing interventions of this? B: The periosteum is injected with the local anesthetic. The good news is that serious complications are relatively rare, especially when healthcare providers are experienced and use ultrasound guidance to perform the procedure. If so, you will be given a The best position for a thoracentesis is sitting up and resting on your arms on a table in front of you. Czd' The name derives from the Greek words thorax ("chest") and centesis ("puncture"). Sometimes, people experiencing a pleural effusion have symptoms like shortness of breath, cough, or chest pain. because the lungs cant inflate fully. Before thoracentesis is performed, a chest x-ray will usually be ordered to confirm the presence of a pleural effusion and to establish the precise location. We do not endorse non-Cleveland Clinic products or services. Fluid from different causes has some different characteristics. The Safe-t-Centesis needle was then introduced through the skin incision into the pleural space using negative aspiration pressure and the red colormetric indicator to confirm appropriate positioning of the needle. This type of thoracentesis usually removes a smaller amount of fluid compared to a therapeutic thoracentesis. Nursing Interventions This means you go home the If not, why not? Thoracentesis shouldnt be painful. determine the etiology of ascites, as well as to evaluate for infection or presence of cancer. leakage of fluid, Report changes in mental status due to %PDF-1.3 % 1 0 obj << /W [ 4503 [ 784 ] ] /Subtype /CIDFontType2 /FontDescriptor 80 0 R /BaseFont /ACDPNI+ArialUnicodeMS /CIDSystemInfo << /Supplement 0 /Ordering (Identity) /Registry (Adobe) >> /DW 1000 /Type /Font /CIDToGIDMap /Identity >> endobj 2 0 obj << /op true /OPM 1 /SM 0.02 /OP true /SA true /Type /ExtGState >> endobj 3 0 obj << /FontFile3 32 0 R /CharSet (/space/t/i/d/m/o/h/s/w/a/period/T/f/e/c/g/n/p/r/u/l/asterisk/L/v/C/colon/Q/comma/y/z) /CapHeight 714 /Ascent 714 /Flags 32 /ItalicAngle 0 /Descent -176 /XHeight 536 /FontName /ACDPKH+HelveticaNeue-Condensed /FontBBox [ -164 -212 1000 932 ] /StemH 84 /Type /FontDescriptor /StemV 84 >> endobj 4 0 obj << /Height 101 /BitsPerComponent 8 /Length 653 /ColorSpace 75 0 R /Width 80 /Filter [ /ASCII85Decode /FlateDecode ] >> stream Theyre minimized by locating the fluid with imaging before the procedure. Diagnostic thoracentesis Indicated for almost all patients who have pleural fluid that is new or of uncertain etiology and is 10 mm in thickness on computed tomography (CT) scan, ultrasonography, or lateral decubitus x-ray (see figure Diagnosis of Pleural Effusion ) diagnostic evaluation, instill medication into the pleural space, and remove fluid (effusion) or air from the pleural space for Your provider will numb your skin before putting the needle in. Thoracentesis yields high diagnostic value and is a generally safe procedure - given that some basic principles are considered. 2021; 13:5242-50. You will stay in the hospital until the catheter Verywell Health's content is for informational and educational purposes only. qualifications are, What would happen if you did not have the test or procedure, Any alternative tests or procedures to think about, Who to call after the test or procedure if you have questions or Thoracentesis is a procedure that takes fluid out from around your lungs (pleural space). These results may help your healthcare provider diagnose your specific medical condition. Your provider usually sends the drained fluid to a lab. The needle or catheter will be removed, and a sterile dressing applied over the insertion site to help prevent infection. The name derives from the Greek words thorax (chest) and centesis (puncture). Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. It does not require a general anaesthetic. improve a patient's breathing, a procedure called a thoracentesis is done. You also might need imaging under other circumstances that increase your risk of complications, such as having multiple needle insertions, having advanced lung disease, if you are on mechanical ventilation, or if a large volume of fluid was removed. Sometimes people also receiving medical imaging after thoracentesis to assess any remaining fluid. Dont remove more than 1000 ml of fluid from the pleural cavity, Thoracentesis Procedure Nursing management:-Place a sterile dressing over the puncture site, Send the specimen to the laboratory for tests, Chart the amount of fluid, color, and time, POSTOPERATIVE CARE: preventing complications and providing reassurance and comfort. Autoimmune disease. - Document color, odor, consistency, and amount of fluid removed, location of insertion site, evidence of leakage, manifestation of, - Change positions slowly to decrease risk of, Assist patient to void, to reduce risk of injury to bladder, Measure abdominal girth and elevate head of bed, Position pt supine with head of bed elevated, Monitor vital signs espaecially BP, pulse (risk hypovolemia), Measure fluid and document amount and color, Access puncture site dressing for drainage, Civilization and its Discontents (Sigmund Freud), Give Me Liberty! for a day or two. Bluegrass Community and Technical College. be resting on an over-bed table. Some pleural effusions reoccur multiple times; sclerosing agents that induce scarring such as talc or tetracycline may be used to prevent recurrence. Ultrasound-guided thoracentesis performed by radiologists has been shown to have fewer complications than blind thoracentesis. The pleural space is the area outside your lungs but inside your chest wall. Maintain pressure at insertion site for several minutes and apply a Used to obtain specimens for diagnostic evaluation, instill meds into pleural space, remove fluid (effusion) or air from pleural space for therapeutic relief Site draped with sterile dressing. Barnes TW, Morgenthaler TI, Olsen EJ, et al. ATI Therapeutic Procedure Paracentesis ATI Therapeutic Procedure University Miami Dade College Course Advanced Medical-Surgical Nursing (NUR2212) Uploaded by DF Dalberte Fourrien Academic year2021/2022 Helpful? way the procedure is done may vary. causes the lung to collapse (pneumothorax). Someone will need to drive you home. Thoracentesis is a respiratory procedure performed with the aim of removing pleural effusion. Report at a scam and speak to a recovery consultant for free. Current Emergency Diagnosis and Treatment. Angiography is an imaging test that uses x-rays and a special dye to see inside the arteries. status every 15mins for the 1st hr & then hourly for the 1st Diagnostic and therapeutic procedures including thoracentesis involve placing needles through the chest wall into the pleural space. Thoracentesis Therapeutic Procedure form 2, surgical perforation of the chest wall and pleural space with a large-bore needle. When enough fluid has been removed, the needle will be taken out. LIVE COURSES. Patients who have a bleeding disorder, or who are taking anticoagulant medications such as warfarin, may be at increased risk of bleeding during the procedure. Rubins, J. The most common causes of pleural effusions are the following: However, other medical causes are also possible, including certain autoimmune diseases and other problems affecting the cardiovascular, gastrointestinal, or pulmonary systems. The needle or tube is inserted through the skin, between the ribs and into the chest. With proper training in both thoracentesis itself and the use of bedside ultrasonography, providers can perform this procedure safely and successfully. What test must you do before performing an arterial puncture? The procedure may also be called a "chest tap." It is normal to have a small amount of fluid in the pleural space. One of the many etiologies of dyspnea in the emergency department is a pleural effusionan abnormal collection of fluid in the pleural space. Sterile gloves . The pleura is a double layer of membranes that surrounds the lungs. Connect you to machines to watch your heart rate and other vital signs. This can help reduce the risk of a potential complication, like pneumothorax. Universal Protocol Always mark the procedure side (confirmed by ultrasound) with your initials and perform a "time out" to verify correct patient, correct site, and correct procedure. It's done using a needle and small catheter to drain excess fluid. Arteries are blood vessels that carry blood away from the heart. considerations. You will be in a sitting position in a hospital bed. Your risks may vary depending on your general health and other factors. Ultrasound-guided thoracentesis performed by radiologists has been shown to have fewer complications than blind thoracentesis. Diagnostic thoracentesis, or sampling of a pleural effusion using a needle through the chest wall, is a simple procedure done to look for the cause of a pleural effusion. The edge of bone is echogenic and gives off a characteristic shadowing. -ensure sterile technique is maintained, -remain absolutely still (risk of accidental needle It can be done as an outpatient procedure, which means youre able to go home afterward. J Thorac Dis. 3. infection. As this happens, youll receive instructions to hold your breath. Therapeutic thoracentesis is associated with the same complications as diagnostic thoracentesis, including vasovagal reaction, pneumothorax, pleural infection, and hemothorax. Close proximity to staff physicians & in protocol-defined environments 2. However, some people opt to take a sedative before the procedure, so they will be awake but sleepy. Failure to identify the deepest pocket of fluid, Failure to identify the diaphragm, avoiding intra-abdominal injury, Failure to use this diagnostic tool for all thoracentesis procedures. Mahesh Chand. The needle and catheter are used to drain the excess fluid in the area. People need to be monitored after getting thoracentesis, even if they are having the procedure as an outpatient. Excess fluid in the pleural space *Monitor vitals,Auscultate lungs for a complications of thoracentesis ati. If mild sedation is being considered, intravenous (IV) medications should be administered to the patient in advance. Your medical team will include your healthcare provider, one or more nurses, and health aids or clinic personnel. Preprocedure nursing actions bronchoscopy. However, you might need to get medical imaging afterward if your symptoms suggest that you might have a complication from thoracentesis, such as shortness of breath or chest pain from a pneumothorax. However, some people need to have thoracentesis repeated if a pleural effusion comes back due to their underlying medical condition. bandage, Check vital signs, record weight, and measure abdominal girth, Administer IV fluids or albumin as prescribed, Assist patient into a comfortable position with HOB elevated to Your provider uses a local anesthetic to numb the surrounding area. Complications from thoracentesis usually arent serious. Managing complications of pleural procedures. also be done to treat symptoms of pleural effusion by removing fluid. accidental needle damage) during procedure New-onset ascites - Fluid evaluation helps to Are allergic to any medications (including anesthetics), latex or tape (adhesives). a) Wear goggles and a mask during the procedure. You will be asked to hold still, breathe out deeply, or hold your Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Paracentesis is a procedure in which a needle or catheter is inserted into the peritoneal cavity, to obtain ascitic fluid for diagnostic or therapeutic purposes. Pleural fluid testing involves removing a sample of this fluid so that it can be analyzed using one or more laboratory methods. Learn faster with spaced repetition. Theyll use imaging (X-ray, ultrasound or CT scan) before the procedure to see where the fluid is and how much of it there is. Potential Complications the provider. Depending on the context, you might need one or more of the following: You also might need a pulmonologist to get involved with your diagnosis and care. It does not require a general anaesthetic. Its easy to get worried even before you even have results. activity for a few days. Thoracentesis can be performed with the patient sitting upright and leaning over a Mayo . CPT 32555: Pleural space aspiration with imaging guidance utilizing thoracentesis, needle, or catheter. - integrity of the airway. You can usually take off the bandage after 24 hours. If there is a large amount of fluid, tubing may be attached to the Performed for Therapeutic reasons such as. NSG 212. to obtain speciments for diagnostic evaluation, instill medication, and remove fluid, -transudates (heart failure, cirrhosis, nephritic syndrome)