NSG 210 Test 3 Study Guide

Sbp is an infection in the abdominal cavity it may

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Unformatted text preview: l peritonitis (SBP)*. It is the first line antibiotic for ascites.  ­Paracentesis: performed for dx examination of ascitic fluid, for tx of massive ascites resistant to nutrition & drug therapy & as a prelude to surgery The removal of fluid from the peritoneal cavity through a puncture made on the abdominal wall under sterile conditions Should be used in combination w/ IV infusion of albumin to help prevent Na retention & H20 shifts into peritoneal space Pre ­procedure: monitor VS; instruct pt to empty bladder to avoid bladder puncture; Semi ­fowlers position Post ­procedure: monitor VS q30min; ax for hypovolemic shock b/c of fluid loss (fluid reaccumulates due to vascular system recompensating); ax site for fluid leakage; administer albumin via IV  ­Transjugular Intrahepatic Portosystemic Shunt (TIPS): treatment of choice for refractive ascites; also done in pts w/ ascites causing respiratory problems A stent is inserted via catheter to the portal vein to divert blood flow & prevent recurrence of fluid accumulation Interventions: include tx & ax measures listed previously. The nurse should also monitor I&O’s, serum ammonia & electrolyte levels, respiratory status, response to therapy & indicators of encephalopathy or hypovolemia.  ­Respiratory support: pt w/ ascites may exhibit hepatopulmonary syndrome (SOB & panting caused by an increase in intra ­abdominal pressure) or hypovolemia. Respiratory interventions should include: Monitor pt’s 02 sats Oxygen therapy Head of bed raised at least 30 degrees, higher if pt can stand it Elevate feet Encourage small, frequent meals (hypovolemia)  ­Teach pt to avoid alcohol, adhere to low Na diet, take meds as prescribed...
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This document was uploaded on 03/29/2014.

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