Therapeutic Paracentesis: Patient Care (Nursing)

00:01 Here's what you need to know about safety for a patient after a paracentesis.

00:06 Your role, your focus, your priority is to monitor this patient to keep them safe.

00:13 One of the things you're going to need to do is put them in high-fowler's position.

00:17 Remember, that's what they're back almost straight up, high-fowler's is not exactly comfortable particularly if the patient has a very large abdomen from ascites, but hopefully you're able to pull off enough fluid to make this more comfortable but that's the recommended position for a patient after a paracentesis is high-fowler's.

00:39 Now monitor the patient's vital signs is another part of the safety process.

00:44 So I'm going to look at heart rate blood pressure and respiratory rate.

00:48 Well, what am I looking for? First of all, know their baseline, know what the trend is for their heart rate, for their blood pressure and their respiratory rate that's critically important information in In any changes.

01:02 If we have some internal leaking going on I would expect their blood pressure to decrease, their heart rate to go up.

01:12 Hopefully you're playing along with me as we did that.

01:15 So if we have some problems what I'm most expect to see is blood pressure may drop, heart rate goes up, respiratory rate is also going to go up that's going to be the early signs as his patient is getting into distress.

01:30 Also keep an eye on that dressing.

01:32 Now what am I looking for on that dressing? I'm looking for signs of that fluid to be leaking out of the abdomen.

01:38 That's not good or I'm looking for bleeding.

01:42 So when it comes to safety after a paracentesis, what am I worried about? Circulatory collapse, so I'm going to monitor vital signs.

01:49 I'm worried about leaking? So I'm going to look at the dressing and the position is I'm going to have them in high-fowler's.

01:57 Those are your priorities.

01:59 When I'm looking at priorities. He's in a test question, I'm always thinking about airway breathing circulation first.

02:06 So the most important information their vital signs.

02:09 Good job.