How do you care for a patient with ascites?
When the patient has tense ascites, 5 or more liters of fluid should be removed to relieve shortness of breath, decrease early satiety, and prevent pressure-related leakage of fluid from the site of the paracentesis.
What is the nurse’s role during a paracentesis?
The role of the nurse is usually to monitor the patient throughout the procedure, administer treatment as directed by the medical team and, depending on local policy, remove the drain at the end of the procedure.
What do you monitor after paracentesis?
Monitor your patient’s vital signs, including temperature, every 15 minutes for 1 to 2 hours after the procedure, or as directed. Measure his abdominal girth for comparison with the baseline measurement. Document the volume, color, and consistency of the fluid.
What is the best position for a patient with ascites?
Patients with severe ascites can be positioned supine. Patients with mild ascites may need to be positioned in the lateral decubitus position, with the skin entry site near the gurney. Position the patient in bed with the head elevated at 45-60 degrees to allow fluid to accumulate in the lower abdomen.
What do you do after paracentesis?
Keep your bandage on for 24 hours after your procedure. You can shower 24 hours after your procedure. Take off your bandage and wash the puncture site with soap and water. You may want to place a clean bandage over the area if fluid is still leaking from the site.
What are the complications of ascites?
Possible Complications Spontaneous bacterial peritonitis (a life-threatening infection of the ascitic fluid) Hepatorenal syndrome (kidney failure) Weight loss and protein malnutrition. Mental confusion, change in the level of alertness, or coma (hepatic encephalopathy)
What are nursing care for patient undergoing paracentesis?
Undertake half-hourly drain site checks, fluid balance monitoring, checks of blood pressure, heart rate and respiratory rate, and temperature monitoring, and observe for any signs of complications, such as leakage of ascitic fluid, infection, bladder and bowel perforation and bleeding.
What should the nurse do before paracentesis?
Before your procedure: Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health. Caregivers may insert an intravenous tube (IV) into your vein.
When do you replace albumin after paracentesis?
2009 AASLD Guidelines recommend albumin replacement after large volume paracenteses if > 4-5 L are removed; 6-8 g/L of albumin (25% concentration) should be given. So, for example, if 10 liters are removed, you would give 60-80 grams of 25% albumin.
What happens after ascites is drained?
Sometimes, ascites builds up again over the following weeks and months after an ascitic drainage. Your doctor or nurse might recommend starting or continuing diuretic (water) tablets to try to help the fluid stay away for longer. Sometimes people need to have another ascitic drainage.
Why do we give albumin after paracentesis?
Indeed, albumin administration is effective to prevent the circulatory dysfunctions after large-volume paracentesis and renal failure and after Spontaneous Bacterial Peritonitis (SBP). Finally albumin represents, associated with vasoconstrictors, the therapeutic gold standard for the hepatorenal-syndrome (HRS).
What position should the PT be in for paracentesis?
The patient is placed in the supine position and slightly rotated to the side of the procedure to further minimize the risk of perforation during paracentesis. Because the cecum is relatively fixed on the right side, the left-lateral approach is most commonly used. Most ascetic fluid reaccumulates rapidly.