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Abdominal Paracentesis

Abdominal paracent

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45 views

Abdominal Paracentesis

Abdominal paracent

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Friends Forever
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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ABDOMINAL PARACENTESIS

INTRODUCTION

The accumulation of large amount of fluid within the peritoneal cavity exerts pressure on the diaphragm
and abdominal organs and vasculature, leading to respiratory compromise and increased work of
breathing. Paracentesis relieves intra abdominal and diaphragmatic pressures, diminishing the work of
breathing.

DEFINITION

Paracentesis is a procedure in which fluid is removed from the peritoneal cavity for diagnostic
and therapeutic purposes.

PURPOSES

1.To obtain fluid samples from the peritoneal space for diagnostic examination.

2.Evacuate fluid from the peritoneal space.

3.Alleviate respiratory compromise related to pressure on the diaphragm caused by ascetic fluid.

COMPLICATIONS

 Perforation of bowel or bladder


 Local or systemic infection
 Hypovolemia, hypotension
 Bleeding from paracentesis site
 Ascetic leak from paracentesis site

PREPARATION OF THE ARTICLES

A tray containing;

 Sterile gloves, gown and mask


 Povidone iodine solution
 Sterile drape
 Lidocaine 2%
 5cc syringe and needle
 25 gauge needle
 10cc syringe-2
 50cc syringe-2
 Trocar with stylet
 Sterile tubes for specimen
 Surgical blade
 Three way stop cock
 Sterile 1L collection bottle
 Suture material with needle
 Gauze and tape

PREPARATION OF THE PATIENT

 Explain the procedure to the patient.


 Obtain an informed consent
 Obtain coagulation profile and platelet count before beginning the procedure.
 Ask the client to void immediately prior to the procedure to decrease the risk of bladder
puncture.
 Position patient as required by the physician. Usual position is supine with head of the bed
elevated 45 to 90 degree or sitting over the side of the bed.
 Provide privacy
PERFORMANCE PHASE

 Wash hands
 Assist the physician with preparing equipment and sterile field.
 Prepare the insertion site with povidone- iodine solution.
 Assist physician with injection of local anesthesia.
 Assist the physician with insertion of trocar and needle.
 Drainage is usually limited to 1-2L.
 Assist the physician with attaching syringes or stopcock and tubing to withdraw peritoneal
fluid.
 Assess the patients vital signs and continuously monitor for complications.
 Once the trocar is removed apply sterile dressing over the wound site.
 Position the patient comfortably.
 Usually the insertion of the needle will be made below the umbilicus.
FOLLOW UP PHASE

 Prepare and sent fluid specimen for laboratory analysis.


 Record amount and characteristics of fluid removed, number of specimens sent to laboratory,
the patients condition during treatment.
 Check blood pressure and vital signs every half hour for two hours, every hour for four hours
and every four hour for 24 hours.
 Watch for leakage or scrotal edema after paracentesis.
 Observe the site for bleeding.
 Wash hands
 Replace the articles.

CONCLUSION

Paracentesis is performed to relieve intra abdominal and diaphragmatic pressures and


diminishing the work of breathing. It can be performed for both diagnostic and therapeutic purposes.
The nurse who assists for paracentesis should know the anatomy and physiology of the lower quadrant
of the abdomen and the normal and abnormal composition of peritoneal fluid.

BIBLIOGRAPHY

1.Sandra MN. The Lippincott manual of nursing practice. 7 th ed. Lippincott: Jaypee brothers; 2003. P.
645-6.

2. Rochelle LB, Maribeth. American association of critical care nurses, procedure manual for critical
care. Philadelphia: WB Saunders company; 1993. P. 549-53.

3. Black JM, Jane HH. Medical surgical nursing. 7 th ed. .Missouri: Elsevier; 2005. P.1509-21.

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