Procedure for Abdominal Paracentesis

An invasive procedure which purpose is to extract fluid accumulation in the peritoneum (ascites).

OBJECTIVES:

1. To withdraw fluid for diagnostic examination.
2. To remove ascitic fluid when large accumulation of fluid causes severe symptoms and is resistant to other therapy.
3. To prepare for other procedure (peritoneal dialysis, ascitic fluid reinfusion, surgery, etc.)
4. To identify presence of blood in the abdomen following trauma.

INDICATION: Presence of fluid in the abdominal cavity.

CONTRAINDICATION:
The patient with bleeding disorders, pregnant women.

CHARTING:
a. Document date, time, vital signs, location of puncture site, presence of any sutures.
b. Document the amount, color and viscosity and odor of aspirated fluid, measurement of abdominal girth, and patient’s weight before and after procedure.

NURSING ALERT:
a. Aspiration of more than 1,500 ml of peritoneal fluid at one time may induce hypovolemic shock. Monitor vital signs every 15 minutes for 1 hour, every 30 mintues for 2 hours, every hour for 4 hours, and every 4 hours for 24 hours to detect delayed reactions.
b. Label specimen as they are collected as #1, #2, #3, #4, etc. Note on laboratory slip if the patient is on antibiotic therapy.

EQUIPMENT:
1. Sterile paracentesis tray and gloves
2. Drape or cotton blankets
3. Skin preparation tray with antiseptic
4. Procaine hydrochloride 1%
5. Collection bottle (vacuum bottle)
6. Specimen bottles and laboratory forms


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