Medical Surgical Nursing

often the first-line therapy. When used with other diuretics, it helps prevent

potassium loss.

 Daily weight loss should not exceed 1 to 2 kg.

 Possible complications of diuretic therapy include fluid and electrolyte

disturbances (including hypovolemia, hypokalemia, hyponatremia .)

C) BED REST

 • In patients with ascites, an upright posture is associated with activation of the

renin-angiotensin-aldosterone system and sympathetic nervous system This

results in reduced renal glomerular filtration and sodium excretion and a

decreased response to loop diuretics. Bed rest may be a useful therapy,

especially for patients whose condition is refractory to diuretics.

D) PARACENTESIS

 Paracentesis is the removal of fluid (ascites) from the peritoneal cavity through

a small surgical incision or puncture made through the abdominal wall under

sterile conditions. Ultrasound guidance may be indicated in some patients at

high risk for bleeding

 Use of large-volume (5 to 6 liters) paracentesis has been shown to be a safe

method for treating patients with severe ascites. This technique, in combination

with the intravenous infusion of saltpoor albumin or other colloid, salt-poor

albumin helps reduce edema by causing the ascitic fluid to be drawn back into

the bloodstream and ultimately excretedd by the kidneys.

 Preprocedure

1. Prepare the pt by providing the information and instructions about the procedure

2. Instruct the patient to void.

3. Gather appropriate sterile equipment

4. Place patient in upright position on edge of bed with feet supported on stool, or

place in chair. Fowler‘s position should be used for the patient confined to bed.

5. Monitoring of blood pressure during the procedure

6. The physician, using aseptic technique, inserts the trocar through a puncture

wound below the umbilicus. The fluid drains from the abdomen through a

drainage tube into a container.

7. Help the patient maintain position throughout procedure.