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DEFINITION:- It is the collection of fluid in the pleural space. It is a type of primary disorder and due to this secondary sign and symptoms will occur.
TYPES:-
1. Transudate ( Hydrothorax)
2. Exudate

1. Transudate:-
In this type fluid passess through the membranes.
2. Exudate:-
It is a leakage of fluid from the blood vessels into the tissues.

TRANSUDATE occurs in non inflammatory condition. It is a process of accumulation of proteins poor, cell poor fluid which move across intact capilliaries walls. For eg.;- increased hydrostatic pressure in the congestive heart fauilure, decrease onchotic pressure in renal and liver disease.
Accumulation of fluids and cells in an area of inflammation for eg;- Any inflammatory condition , pulmonary malignancies, nephrotic syndrome occurs due to exudate condition.
PATHOPHYSIOLOGY:-
TRANSUDATE:-
Any alteration in the formation and reabsorbation of pleural; fluid due to imbalance in hydrostatic and onchotic pressure . It has low content of protein & the nature of fluid is clear & pale yellow./

EXUDATE:-
It occurs due to any inflammation and bacterial infection, tumors which causes exudation process . It has a high protein content & fluid is dark yellow & amber.

Pleural effusion

CLINICAL FEATURES:-
1. Pleuritic pain
2. Progressive dyspnea
3.Decreased cheast wall movement
4. fever
5. chills
6. Malignant effusion may result in dyspnea and coughing
7. Malaise
DIAGNOSTIC EVALUATIONS:-
1. Physical Examination
2. Pleural biopsy
3. Chest X-ray
4. Pleural fluid analysis
5. C T scan
6. Thoracentesis

MEDICAL MANAGEMENT:-
1. To discusss he underlying cause to prevent reaccumulation of fluid to relief discomfort &dyspnea are the purpose of management including thoracentessis aspiration through syringe.
2. Provide appropriate antibiotics
3. Provide diuretics therapy

NURSING MANAGEMENT:-
1. Take care of patient and prepare him for thoracentesis procedure
2. Reduce the pain by maintain the position &administering analgesics
3. Educate the patient & his family regarding care of drain tube if the client is an out patient.
4. Frequent turning of the patient position will facilitate drainage of the accumulation fluid.

Description:- Basal Cell Carcinoma
Definition:- Basal cell carcinoma is a type of skin Cancer; Basal cell carcinoma often appears as a Waxy bump, though it can take other form. Basal cell carcinoma occurs most often on areas of the skin that are often exposed to the sun, such as own face and neck.
Causes:- (1). Basal cell carcinoma occurs when one of the skin’s basal cell develops a mutation in its DNA, a Mutation in the DNA causes a Basal Cell to multiply rapidly and continue growing when it would normally die. Eventually the accumulating abnormal cell may form a Cancerous tumor
(2). Ultraviolet light & other causes; Much of the damage to DNA in basal cells is thought to result from ultraviolet(UV) radiation found in sunlight and in commercial tanning beds.But sun exposure doesn’t explain skin cancers that develop on skin not ordinarily exposed to sunlight. This indicates that other other factors may contribute to own risk of skin cancer , such as being exposed to toxic substances or having a condition that weakens own immune system
Symptoms:- Although a general warning sign of skin cancer is a sore that won’t heal or that repeatedly bleeds and scabs over, basal cell cancer may also appear as:-
1) A pearly white or waxy bump,
2) Often with visible blood vessels, on face , ears or neck.
3) A flat, scaly, brown or flesh-colored patch on back or chest.
4) More rarely, a white, waxy scar

Remedies:-
1). Eat at least 5 servings of fruits and vegetables each day, especially those food rich in the Antioxidants Beta Carotene, vitamin C , and citrus fruits.
2). Include in Diet plenty of whole grains, sea vegetables, beans and soyabeans, hot peppers, cabbage, tomatoes, onions, rosemary, garlic grapes, licorice root, green tea, white fish, mushrooms.
3). Avoid red Meat, processed foods, red and yellow dyes, monosodium glutamate, nitrites(found in cured meats), saccharin sugar, dairy products, alcohol, caffeine containing drinks.