SERVICE EXCELLENT” MEDICAL SURGICAL NURSING MANAGEMENT OF Mr. M WITH PLEURA EFUSION AT H. ADAM MALIK MEDAN HOSPITAL NORTH SUMATERA PROVINCE YEAR 2025

Abstract

Pleural effusion is a condition where fluid accumulates in the pleural lining of the lungs. This fluid can be either transudate or exudate, depending on the cause. This condition occurs when the body is unable to reabsorb the fluid. Some of the contributing factors include increased pressure in the subpleural capillaries or lymphatic vessels, increased capillary wall permeability, low blood plasma oncotic pressure, increased negative pressure in the pleural cavity, and impaired lymphatic drainage function. More permeable capillary walls allow fluid to escape easily, plus low levels of plasma protein that reduce the ability of blood to retain fluid, causing the lymphatic system to not be optimal in draining fluid from the pleural cavity. Based on WHO data (2021), the global prevalence of pleural effusion reached 37.5% or 828,136 cases. Of this number, 14.1% (116,792 cases) were caused by lung disease, 11.4% (94,420 cases) by pneumonia infection, 8.5% (70,391 cases) by heart failure, and 5.5% (45,547 cases) by cirrhosis hepatis. In Indonesia, according to the , the prevalence of pleural effusion reached 2.7% or around 1.39 million people. In North Sumatra Province, based on data from the Health Office (2021), the incidence rate has increased every year: 1.2% in 2019, rising to 1.5% in 2020, and 2.7% in 2021, with a total of 139 cases. At Haji Adam Malik General Hospital, there were 273 patients with pleural effusion in 2020.(Feni Fitriani, 2021)(Chairman Guideline Committee, 2022)(Supriantarini & Afifah, 2025)(Habas et al., 2024)