Set of activities performed by the nurse in conjunction with the physician to perform a paracentesis on the patient.
Objectives:
– Evacuate the abdominal cavity partially or totally of ascitic fluid. – Obtain a sample of fluid from the patient’s abdominal cavity for diagnostic purposes.
Equipment:
– 2 sterile drapes. – Trough. – Sharps container.
Material:
– 2 intramuscular and intravenous needles. – 2 ampoules of local anesthetic. – Antiseptic solution. – Sterile gauze. – Sterile gloves. – Non sterile gloves. – 1-2 syringes of 5-10 cc. – Tubes for analysis. – Serum injector equipment. – Graduated container – Peripheral catheter. – Ascitic fluid analytical test request form. – Nursing records.
Procedure:
– Perform hand washing. – Prepare the material. – Preserve the patient’s privacy. – Check that the patient and family have received medical information about the procedure. – Request the patient’s cooperation. – Ask the patient to urinate, otherwise assess the need for bladder catheterization. – Place the patient in the Fowler or supine position. – Measure blood pressure. – Ask the patient not to move and to breathe slowly. – Prepare sterile field and place the necessary material on it. – Put on non-sterile gloves. – Apply antiseptic solution to the puncture site. – Assist the physician during the procedure. – Prepare sterile tubes to collect the ascitic fluid sample, if necessary. – Monitor the rate of fluid output and its characteristics, if the paracentesis is evacuating. – Monitor blood pressure during and at the end of the evacuation. – Place dressing on the puncture site. – Monitor periodically if the dressing becomes stained, assess the amount and color of fluid drained. – Change the dressing if necessary. – Begin to ambulate progressively. – Collect the material. – Remove gloves. – Wash hands. – Identify the tubes with the patient’s data and send to the laboratory with the request for analysis. – Record in the nursing documentation: procedure performed, date and time, incidents and patient’s response.
Observations:
Assess the patient after the procedure in case of bleeding.
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