Medical Surgical Nursing

(Tina Sui) #1

Assessment and Diagnostic Evaluation


 The presence and extent of ascites are assessed by percussion of the abdomen.
When fluid has accumulated in the peritoneal cavity, the flanks bulge when the
patient assumes a supine position. The presence of fluid can be confirmed either
by percussing for shifting dullness or by detecting a fluid wave. Daily
measurement and recording of abdominal girth and body weight are essential to
assess the progression of ascites and its response to treatment.

Medical Management A) DIETARY MODIFICATION


 The goal of treatment for the patient with ascites is a negative sodium balance
to reduce fluid retention. Table salt, salty foods, salted butter and margarine,
and all ordinary canned and frozen foods should be avoided.

 In the meantime, the taste of unsalted foods can be improved by using salt
substitutes such as lemon juice, oregano, and thyme.

B) DIURETICS


 Use of diuretics along with sodium restriction is successful in 90% of patients
with ascites. Spironolactone (Aldactone), an aldosterone blocking agent, is most
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