Care of the
For patients with
Ascities- an overview.
The peritoneum is the lining of the abdominal cavity which supports the organs in the abdomen and helps protect them from infection.
The inside surface of the peritoneum produces fluid (known as peritoneal fluid). This fluid allows the organs to slide against each other and the peritoneum. When there is excess fluid in the abdominal cavity, this is known as Ascities. Paracentesis is a drainage procedure that removes some of this fluid. This is known as Large Volume Paracentesis (LVP), which is the removal of 5L or more of ascitic fluid in a single session.
In a majority of patients ascities responds to dietary sodium restriction (no added salt diet) and diuretics (Runyon 1998).
However, patients with advanced cirrhosis often present with marked abdominal distension due to abundant ascities which can often result in respiratory problems, in which case Paracentesis often provides quick relief (Gines 1987).
Furthermore, repeated paracentesis is needed in patients with advanced cirrhosis who are unresponsive to intensive diuretic treatment, or in those that develop adverse effects, (for example Hypotension, hyponatraemia, hepatic encephalopathy and renal failure) from the intensive diuretics.
This teaching will cover the care of a patient with an abdominal Paracentesis in situ.
Therapeutic Paracentesis is performed either to resolve large volume ascities, relieving abdominal discomfort and/or dyspnoea, to treat ascities that has not responded to medical therapy, or to enable easier ultrasound examination in patients with massive ascities.
There is no specific training given to care or assist in the insertion of a paracentesis, but all nurses are accountable for their own professional practice and only assist with the procedure if...