الفهرس 
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Abstract
Summary
Pleural effusion is a syndrome occurs frequently in hospitalized patients, and defined as a fluid collection between the pleural leaves due to local/systemic disease of the pleura, lung or extra pulmonary organs. The role of the nurse in pleural effusion management is multifaceted, and comprises careful monitoring of the patient’s vital signs, central venous pressure (CVP), level of consciousness and fluid input /urine output, measuring chest, pulmonary function and use chest physiotherapy which can enhance and improve chest expansion and pulmonary function of these patients
Therefore, the aim of this study was to evaluate the effect of implementing standardized nursing care on patient outcomes for critically ill patients with pleural effusion. The design of this study was true experimental (randomized prospective) research design. This study was carried out in General, Trauma and Chest intensive care units at Assiut University Hospitals.
A convenience sample of 60 male and female adult patients were taken; the patients were classified into two equal groups, 30 patients for each group.
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Three tools were utilized to collect data, which are; Tool I: pleural effusion assessment sheet. Tool II: Chest physiotherapy sheet. Tool III: Patients’ outcomes evaluation sheet. A pilot study carried out in order to assess the feasibility and applicability of the tools and necessary modifications were done. The pilot study was done on 6 patients who were excluded from the study.
The main results:-
As regard to present illness, results revealed that patients with pneumonia, acute kidney injury (AKI) and pulmonary embolism were the high risk group for pleural effusion, and it was observed that pneumonia as the most common cause contributing to pleural effusion in less than half of patients in study group and in one third of patients in control group.
As regard to chest expansion, results show that there was significant improvement of chest expansion in study group than control group after exercise as results showed that there was a statistical significant difference between study and control groups in the first day of the study and there were highly statistical significant difference between study and control groups regarding chest expansion after exercise after three days of the study and in the last day of the study.
Regarding to bedside pulmonary function tests, results showed that there was significant improvement of pulmonary function in study group than control group after exercise as results showed that there was highly statistical significant difference between study and control groups in the first day of the study, after three days of the study and in the last day of the study regarding Cardiopulmonary Reserve (CPR) and Volume capacity (VC).
Regarding to fluid balance, it was observed that there were statistical significant differences between study and control groups in relation to total output per day and balance in the first day of the study, after three days of the study and in the last day of the study.
Regarding to complications, it was found that one third of patients in control group developed pulmonary edema and less than one third of patients in the study group had developed pulmonary edema with a statistical significant difference between study and control groups in relation to developing pulmonary edema.