Thoracentesis Procedure, Nursing Care Plans & Management

The optimal puncture site for the process ought to keep away from any recognized vascular struc- tures within the abdominal wall. One can then decide the “ascites safety zone”, or the fluid-filled area be- low the belly wall and above the bowel and mesentery, into which a needle could be safely positioned (Fig- ure 16). The presence of ascites additionally predisposes to spontaneous bacterial peritonitis , a potentially life threaten- ing an infection attributable to transmigration of bacteria into the peritoneal fluid. Unfortunately, physician’s medical impression has a limited sensitivity for this analysis. One research demonstrated a sensitivity of 76% and specific- ity of 34% for the doctor impression in accurately detecting SBP .

Ascites is an abnormal accumulation of fluid within the abdomen, which might differ from small quantities to many litres. It could be graded from 1 to 3 based on the severity of signs . This article discusses the pathophysiology, analysis and management of ascites, in addition to implications for nursing practice.

A resonant sound ought to then be heard, as air ought to have stuffed the realm beforehand occupied by fluid. This signal is called ‘shifting dullness’ and is indicative of ascites (Innes et al, 2018; Bickley et al, 2007). Liver cirrhosis and portal hypertension account for 75% of all ascites circumstances . Portal hypertension, arterial vasodilatation, neurohumoral activation, and renal dysfunction are the proposed pathogenesis factors .

Changes in colour, pulse, respiration, blood stress etc. must be noted and reported to the physician instantly. These are the indications that the consumer goes into vascular shock and collapse. The drainage receptacle ought icl4+ bond angle to be raised on the stool. Strict aseptic approach must be adopted to stop introduction of infection into the peritoneal cavity. Record the process on the nurse’s report with date and time.

Attach the 60-mL syringe to the three-way stopcock and aspirate to acquire ascitic fluid, and distribute it to the specimen vials. Use the three-way valve as needed to regulate fluid flow and prevent leakage when no syringe or tubing is attached. Connect one end of the fluid assortment tubing to the stopcock and the other end to a vacuum bottle or a drainage bag. Use one hand to firmly anchor the needle and syringe securely in place to prevent the needle from coming into additional into the peritoneal cavity. Use the opposite hand to carry the stopcock and catheter and advance the catheter over the needle and into the peritoneal cavity all the means in which to the skin.