Nursing Care for Pleural Effusion Patients Through Semifowler Position on Hemodynamic Status: A Case Report
DOI:
https://doi.org/10.53713/htechj.v3i2.320Keywords:
Hemodynamic Status, Semifowler, Pleural EffusionAbstract
Pleural effusion is the accumulation of fluid in the pleural cavity or membrane that separates the inner chest wall from the lungs. Pleural effusion can affect hemodynamics because increased intrapleural pressure can push organs in the mediastinum. Providing a semi-fowler position is one of the nursing interventions that is expected to improve hemodynamic status in patients with pleural effusion. This study aims to determine the implementation of nursing care for patients with pleural effusion by applying the semi-fowler position to hemodynamic status in the Catleya Room, dr. Soebandi Hospital, Jember. The research method in this study uses a case study. The respondents and place in this study were Mr. T. with pleural effusion in the Catleya Room of RSD dr. Soebandi Jember. Semifowler position intervention was given for 3 days with a duration of 2 hours. The results of this study indicate that on the first day, there was a decrease in blood pressure, MAP, and respiratory rate. While the pulse rate and oxygen saturation increased. On the second and third day, of the application of the semifowler position, the results showed that there was a decrease in respiratory rate and an increase in pulse rate and oxygen saturation. While there were no hemodynamic changes in blood pressure and MAP. The conclusion of this study is that the implementation of the semi-Fowler position has an effect on hemodynamic status, especially on reducing respiratory rate and increasing pulse rate and oxygen saturation.
References
Alan, N., & Khorshid, L. (2020). The effects of different positions on saturation and vital signs in patients. Nursing in Critical Care, 26(1), 28-34. https://doi.org/10.1111/nicc.12477
Ardiyanto, M. M. A. S., Zulfatul A’la, M., Tri Gunarto, S., & Zainur Ridla, A. (2024). Asuhan Keperawatan Pada Penurunan Curah Jantung Dengan Intervensi Posisi Semi fowler: Studi Kasus Pada Pasien Acute Decompensated Heart Failure (ADHF) Di Ruang ICCU. Jurnal Ilmiah Ners Indonesia, 5(1), 1–13. https://doi.org/10.22437/jini.v5i1.31655
Bediwy, A. S., Al-Biltagi, M., Saeed, N. K., Bediwy, H. A., & Elbeltagi, R. (2023). Pleural effusion in critically ill patients and intensive care setting. World Journal of Clinical Cases, 11(5), 989–999. https://doi.org/10.12998/wjcc.v11.i5.989
Bojan, M., & Pouard, P. (2023). Hemodynamic management. Anesthesia for Congenital Heart Disease, 494-526. https://doi.org/10.1002/9781119791690.ch21
Dmytriiev, D., Nazarchuk, O., Melnychenko, M., & Levchenko, B. (2022). Optimization of the target strategy of perioperative infusion therapy based on monitoring data of central hemodynamics in order to prevent complications. Frontiers in Medicine, 9, 935331. https://doi.org/10.3389/fmed.2022.935331
Dragomir, L., Marina, V., Anghele, M., & Anghele, A. (2021). Clinical or Imaging Diagnosis of the Current Medical Practice for Superior Vena Cava Syndrome? Diagnostics, 11(11), 2058. https://doi.org/10.3390/diagnostics11112058
El Haque, I. T., Gunawan, A., & Puspayanti, S. (2021). Application of Semi Fowler Position to Inaffectiveness of Breathing Patterns in Congestive Heart Failure (Chf) Patients. Jurnal VNUS (Vocational Nursing Sciences), 3(1), 29–37. https://doi.org/10.52221/jvnus.v3i1.325
Ferreiro, L., Toubes, M. E., Suárez-Antelo, J., Rodríguez-Núñez, N., & Valdés, L. (2024). Clinical overview of the physiology and pathophysiology of pleural fluid movement: a narrative review. ERJ Open Research, 10(5). https://doi.org/10.1183/23120541.00050-2024
Hassan, M., Patel, S., Sadaka, A. S., Bedawi, E. O., Corcoran, J. P., & Porcel, J. M. (2021). Recent Insights into the Management of Pleural Infection. International Journal of General Medicine, 14, 3415–3429. https://doi.org/10.2147/IJGM.S292705
Hu, K., Chopra, A., Kurman, J., & Huggins, J. T. (2021). Management of complex pleural disease in the critically ill patient. Journal of Thoracic Disease, 13(8), 5205. https://doi.org/10.21037/jtd-2021-31
Ismail, A. S., Mohammad, S. Y., & Mourad, A. H. (2021). Effect of Body Position on Oxygenation and Hemodynamic Status among Patients with Traumatic Brain Injury. Evidence-Based Nursing Research, 3(2), 15. https://doi.org/10.47104/ebnrojs3.v3i2.191
Kapur, N. K., Kiernan, M. S., Gorgoshvili, I., Yousefzai, R., Vorovich, E. E., Tedford, R. J., ... & Karas, R. H. (2022). Intermittent occlusion of the superior vena cava to improve hemodynamics in patients with acutely decompensated heart failure: the VENUS-HF early feasibility study. Circulation: Heart Failure, 15(2), e008934. https://doi.org/10.1161/CIRCHEARTFAILURE.121.008934
Khairnar, S. V., Jain, D. D., Tambe, S. M., Chavan, Y. R., & Amin, P. D. (2021). Nebulizer Systems: A New Frontier for Therapeutics and Targeted Delivery. Therapeutic Delivery, 13(1), 31–49. https://doi.org/10.4155/tde-2021-0070
Lail, N. A., Efendi, R., Noviyan, A. T., Lestari, I., & Fausi, A. A. (2024). Nursing Care for Pneumonia Patients. Al Makki Health Informatics Journal, 2(2), 184-189. https://doi.org/10.57185/hij.v2i2.22
Lorente, J. V., & Ignacio, M. (2023). Hypotension prediction index: From reactive to predictive hemodynamic management, the key to maintaining hemodynamic stability. Frontiers in Anesthesiology, 2, 1138175. https://doi.org/10.3389/fanes.2023.1138175
Marchant, B., Kingeter, A., & McEvoy, M. D. (2022). Electrolytes and Acid-Base Balance. In Anesthesia Student Survival Guide: A Case-Based Approach (pp. 269-300). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-98675-9_14
Moschopoulos, C. D., Dimopoulou, D., Dimopoulou, A., Dimopoulou, K., Protopapas, K., Zavras, N., Tsiodras, S., Kotanidou, A., & Fragkou, P. C. (2023). New Insights into the Fluid Management in Patients with Septic Shock. Medicina, 59(6), 1047. https://doi.org/10.3390/medicina59061047
Narayan, M., Meredyth, N., Aveson, V., & Barie, P. S. (2022). Pulmonary Infections. In Management of Chest Trauma: A Practical Guide (pp. 321-344). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-06959-8_28
Patel, K. M., Ullah, K., Patail, H., & Ahmad, S. (2021). Ultrasound for pleural disease. Beyond a pocket of pleural fluid. Annals of the American Thoracic Society, 18(5), 749-756. https://doi.org/10.1513/AnnalsATS.202008-948CME
Pinsky, M. R., Cecconi, M., Chew, M. S., De Backer, D., Douglas, I., Edwards, M., ... & Vincent, J. L. (2022). Effective hemodynamic monitoring. Critical Care, 26(1), 294. https://doi.org/10.1186/s13054-022-04173-z
Purba, A. G., Simanjuntak, E., Ginting, S., & Kalvin, F. (2024). Training on The Application of Nebulisation with The Semi Fowler Position in Controlling The Breath Frequency of Bronchial Asthma Patients At The GM Hospital. JURNAL PENGMAS KESTRA (JPK), 4(1), 71-74. https://doi.org/10.35451/jpk.v4i1.2194
Purnamayanti, N. K. D. ., Tondok, S. B. ., Susasnto, W. H. A. ., & Rohmani, R. (2023). Impact of Semi-Fowler’s Position in Chronic Heart Failure (CHF) Patients: Scoping Review. Jurnal Penelitian Pendidikan IPA, 9(11), 1229–1236. https://doi.org/10.29303/jppipa.v9i11.5074
Rahmawati, E. Y., Pranggono, E. H., & Priambodo, A. P. (2021). The Effect of Lateral Position with Head Up 45° on Oxygenation in Pleural Effusion Patients. Jurnal Keperawatan Padjadjaran, 9(2), 124–130. https://doi.org/10.24198/jkp.v9i2.1672
Saraswati, N. P. S. D., Pratiwi, S. H., & Sari, E. A. (2024). Dyspnea management in patients with pneumonia and coronary artery disease: A case study. Malahayati International Journal of Nursing and Health Science, 7(3), 340–350. https://doi.org/10.33024/minh.v7i3.132
Sari, D. S. I., Nistiandani, A., Siswoyo, & Umayanah. (2023). An Application of Semi-Fowler Positioning to Overcome Nursing Problems Ineffective Breath Patterns in Clients with Chronic Kidney Disease: a Case Study. Jurnal Kegawatdaruratan Medis Indonesia, 2(1), 109–114. https://doi.org/10.58545/jkmi.v2i1.71
Simonte, R., Cammarota, G., Vetrugno, L., De Robertis, E., Longhini, F., & Spadaro, S. (2023). Advanced Respiratory Monitoring during Extracorporeal Membrane Oxygenation. Journal of Clinical Medicine, 13(9), 2541. https://doi.org/10.3390/jcm13092541
Siopi, S. A., Antonitsis, P., Karapanagiotidis, G. T., Tagarakis, G., Voucharas, C., & Anastasiadis, K. (2024). Cardiac Failure and Cardiogenic Shock: Insights Into Pathophysiology, Classification, and Hemodynamic Assessment. Cureus, 16(10), e72106. https://doi.org/10.7759/cureus.72106
Soemah, E., Savinda Afista, & Agus Haryanto. (2024). The Effect of Giving Semi Fowler Position in Reducing Ineffective Breathing in Chronic Kidney Disease (CKD) Patients at RSUD Ibnu Sina Gresik Hospital (Case Study Research). Journal of Scientific Research, Education, and Technology (JSRET), 3(1), 54–61. https://doi.org/10.58526/jsret.v3i1.315
Sorino, C., Mondoni, M., Lococo, F., Marchetti, G., & Feller-Kopman, D. (2022). Optimizing the management of complicated pleural effusion: From intrapleural agents to surgery. Respiratory Medicine, 191(November 2021), 106706. https://doi.org/10.1016/j.rmed.2021.106706
Stewart, J. M., & Pianosi, P. T. (2020). Postural orthostatic tachycardia syndrome: A respiratory disorder? Current Research in Physiology, 4, 1-6. https://doi.org/10.1016/j.crphys.2021.01.002
Taha, A. S., Omran, E. S., & Mahmoud, E. A. (2021). Effectiveness of Semi-fowler's Position on Hemodynamic Function among Patients with Traumatic Head Injury. Journal of Nursing Science Benha University, 2(1), 89-108. https://doi.org/10.21608/jnsbu.2021.159644
Wahyudi, F., & Saputra, R. D. (2025). Hydropneumothorax Secondary to Community-Acquired Pneumonia with Broncholith: A Case Report. Bioscientia Medicina: Journal of Biomedicine and Translational Research, 9(1), 6005-6018. https://doi.org/10.37275/bsm.v9i1.1170
Wirawan, N. ., Periadi, N., & Iqbal Kusuma, M. . (2022). The Effect of Intervention on Semi Fowler and Fowler Positions on Increasing Oxygen Saturation in Heart Failure Patients. KESANS : International Journal of Health and Science, 1(11), 992–1006. https://doi.org/10.54543/kesans.v1i11.104
Yildiz, A. B., Vehbi, S., Covic, A., Burlacu, A., Covic, A., & Kanbay, M. (2023). An update review on hemodynamic instability in renal replacement therapy patients. International Urology and Nephrology, 55(4), 929-942. https://doi.org/10.1007/s11255-022-03389-w
Zunzunwala, S., & Vardhan, D. V. (2023). Efficacy of lung boost device on pulmonary function and chest expansion in pleural effusion patient: a randomized control trial protocol. F1000Research, 12, 1115. https://doi.org/10.12688/f1000research.140483.1