Paracentesis

Procedure to remove fluid from the peritoneal cavity

Definition

Paracentesis is a diagnostic or therapeutic procedure in which a needle is inserted into the peritoneal cavity to withdraw ascitic fluid. It relieves symptomatic ascites and helps diagnose cause.

Indications

  • Tense, symptomatic ascites
  • Suspected spontaneous bacterial peritonitis (SBP)
  • Evaluation of new ascites

Pre-Procedure Nursing Care

  • Informed consent
  • Have patient VOID IMMEDIATELY before procedure (prevent bladder perforation)
  • Baseline vital signs, weight, abdominal girth
  • Position sitting upright or high-Fowler's

Post-Procedure Nursing Care

  • Monitor vital signs every 15 minutes × 4, then hourly
  • Assess for hypotension (large volume removal >5 L)
  • Albumin may be given to prevent post-paracentesis circulatory dysfunction
  • Document fluid color, amount, and send for analysis
  • Monitor for peritonitis, bleeding, bladder injury

NCLEX Relevance

Void before procedure! Monitor BP after large-volume paracentesis.