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1. To withdraw fluid for diagnosticexamination.2. To remove ascitic fluid when large
accumulation of fluid causes severesymptoms and is resistant to othertherapy.3. To prepare for other procedure
(peritoneal dialysis, ascitic fluidreinfusion, surgery, etc.)4. To identify presence of blood in theabdomen following trauma.
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y a. Aspiration of more than 1,500 ml ofperitoneal fluid at one time may inducehypovolemic shock. Monitor vital signs
every 15 minutes for 1 hour, every 30mintues for 2 hours, every hour for 4hours, and every 4 hours for 24 hoursto detect delayed reactions.
b. Label specimen as they are collectedas #1, #2, #3, #4, etc. Note onlaboratory slip if the patient is onantibiotic therapy.
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1. Sterile paracentesis tray andgloves
2. Drape or cotton blankets
3. Skin preparation tray withantiseptic
4. Procaine hydrochloride 1%
5. Collection bottle (vacuum bottle)6. Specimen bottles and laboratoryforms
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y 1. Explain procedure to the patient.Rationale: This may reduce thepatients fear and anxiety.
y 2. Record the patients vital signs.Rationale: Provides baseline values forlater comparison.
y 3. Have the patient void beforetreatment is begun. See that consent
form has been signed.Rationale: This will lessen the dangerof accidentally piercing the bladderwith the needle or trocar.
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y 4. Position the patient in Fowlersposition with back, arms and feet
supported (sitting on the side of thebed is frequently used position).Rationale: The patient is morecomfortable and steady position canbe maintained.
y 5. Drape the patient with sheetexposing abdomen.
Rationale: Minimizes exposure ofpatient and keeps him warm.
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y 1. Assist physician in preparing skinwith antiseptic solution.Rationale: This is considered a minor
surgical procedure, requiring asepticprecautions.y 2. Open sterile tray and package of
sterile gloves; provide anesthetic
solution.y 3. Have collection bottle and tubing
available.
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y 4. Assess pulse and respiratory statusfrequently during procedure; watch for pallor,
or syncope.Rationale: Preliminary indications for shockshould be watched for. Keep emergency drugsavailable.
y 5. Physician administers local anesthesia andintroduces No. 20 needle or trocar.
y 6. Needle or trocar is connected to tubing andvacuum bottle or syringe; fluid is drained fromperitoneal cavity.Rationale: Drainage is usually limited to 1-2liters to relieve acute symptoms and minimize
risk of hypovolemia and shock.y 7. Apply dressing when needle is withdrawn.
Rationale: Elasticised adhesive patch iseffective, serving as waterproof adheringdressing.
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y 1. Assist the patient to be comfortableafter treatment.
y 2. Record amount and kind of fluidremoved, number of specimens sent to
laboratory, the patients condition throughtreatment.y 3. Check blood pressure and vital signs
every half hour for two hours, every hourfor 4 hours, and every 4 hours for 24
hours.Rationale: Close observation will detectpoor circulatory adjustment and possibledevelopment of shock.
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y 4. Usually, a dressing is sufficient;
however, if the trocar wound appearlarge, the physician may close theincision with sutures.
y 5. Watch for leakage and/or scrotaledema after paracentesis.Rationale: If seen, notify thephysician at once.
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