Nursing Procedure During Paracentesis Abdominus

A nursing procedure used by professional nurses and student nurses during training to tap free fluid within the peritoneal cavity.

PARACENTESIS ABDOMINIS

Purpose:        To tap free fluid within the peritoneal cavity

Requirements on a Trolley:

Top Shelf       – Paracentesis Pack Containing:  1 Receiver

1 Galipot

1 Gate clip

Trocar and Cannula

2 Pieces Rubber tubing (large and 1 small)

1 Bard Parker handle with blade

2 Towels (one for hand, one for draping) 1 2cc.  Glass Syringe

1 Test Tube

1 Toothed Dissecting forceps

1 Michael clip plus applicator

Artery forceps

2 injection needles

1 Safety pin

3 gauze swabs

1 wool pad

Wool swabs

Bottom Shelf: Gloves (correct size for Doctor)

Savlon 1 – 3 in spirit for cleaning the skin

Local anaesthetic (2% Xylocaine)

Large abdominal Binder

Winchester bottle on a small tray Strapping and scissors in receiver Stimulant tray

1 receiver for used swabs

1 receiver for used forceps Mask container

1 Mackintosh apron

1 Mackintosh drape

Preparation of the Patient:

  1. Explain the procedure to the patient. first, to make him at ease.
  2. Screen the bed.  Offer a bedpan or urinal.
  3. If the patient is unable to empty his bladder, inform the doctor who may order catheterization.  The main hazard of this procedure is the puncture of a distended bladder.
  4. Shave the abdomen if necessary
  5. Sit the patient up so that fluid may drain downwards and forward to an accessible position.
  6. Open the pyjama jacket and cover the chest
  7. Slip the binder behind back
  8. Fold the bed clothes to the thighs and cover with mackintosh
  9. Stand the Winchester bottle on the floor bedside the bed. The assistant open the pack and pours the lotion for the Doctor.  The Doctor checks the xylocain 2% and draws it up.

METHOD:

  1. After scrubbing, the Doctor dries his hands with a sterile towel and puts on his gloves
  2. He cleans the skin, drapes it with a large towel
  3. He instills the local anaesthetic half way between the umbilicus and the symphysis pubis to one or other side of the midline.
  4. He assembles the Southey’s tube and then nicks the skin with scalpel to facilitate the introduction of the tube, which will then pass easily into the abdomen

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