NSG 210 Test 3 Study Guide

It is the first line antibiotic for ascites

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Unformatted text preview: may be pushed out, orthopenia, increased respirations, bulging flanks (massive ascites), shifting dullness (minimal ascites), fluid & electrolyte imbalances Ax: presence of fluid can be detected by percussion of the abdomen for shifting dullness, detection of a fluid wave, daily measurement of abdominal girth & daily weights.  ­For abdominal girth, measurement is taken at largest diameter (umbilicus), at the end of exhalation. Mark the flank & midline measurement on the pt.  ­For fluid wave detection, pt lies supine while examiner places hands along the pt’s flanks. One flank is striked while the examiner detects a fluid wave with the other hand. An assistant’s hand is placed along the pt’s midline to prevent the fluid wave from going into the abdominal wall tissues. (pg 1125 has picture) Fluid wave likely only with large amounts of fluid. Tx: includes nutrition & drug therapy, bed rest, paracentesis & TIPS procedure  ­Nutrition Therapy: restrict Na to 1 ­2g daily. Avoid table salt, salty foods, salted butter, canned & frozen foods Use substitutes such as lemon juice, oregano & other herbs Avoid salt substitutes unless approved by physician Pt should use powdered, low ­Na milk & milk products If ascites becomes refractory (occurs again), daily Na may be lowered to 500mg Daily vitamin supplements of thiamine, folate & multivitamins  ­Drug Therapy: Diuretics & Antibiotics Spironolactone (Aldactone) is a K ­sparing diuretic & is the first line therapy for pts w/ ascites from cirrhosis Lasix is K ­wasting diuretic & is a second line therapy Norfloxacin (Noroxin) is a prophylactic antibiotic used as a preventive measure & treatment of spontaneous bacteria...
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