Therapeutic Paracentesis: Refractory Ascites (Nursing)

by Rhonda Lawes

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    00:00 The refractory ascites is a ascites that is unresponsive to the common treatment.

    00:05 So when we try sodium restriction diet and a high dose diuretic and it doesn't work.

    00:11 We don't decrease the amount of ascites or get it to a manageable level that's considered refractory ascites.

    00:18 Because it's going to pop right back up after paracentesis.

    00:22 So we try the diet, we try the diuretics that didn't work.

    00:25 We try the paracentesis, we pull off a fair amount of fluid and then it just fills right back up after the paracentesis.

    00:34 That's the definition of refractory ascites and this has significant impact on quality of life.

    00:40 I'm going to give you an even better picture way to think about refractory ascites.

    00:46 There's our picture of ascites the ocean of blue, you see the tubing that leads to the drainage container.

    00:51 This is a fairly rare occurrence since less than 10% of patients with cirrhosis and ascites develop into liver refractory ascites, okay.

    01:02 So we're talking about a fairly rare occurrence, but when it happens, it's a big deal.

    01:08 We've got multiple cups there to remind you.

    01:10 They're putting out large volumes.

    01:13 Let me give you some actual numbers to understand when I say large volumes how big I mean? These patients with refractory ascites accumulate as much as 10 to 15 liters of ascites every 15 days.

    01:29 10 to 15 liters every 15 days.

    01:31 So just a smidgen over two weeks.

    01:35 You're now carrying around, seven and a half two liter bottles of Diet Mountain Dew worth of fluid in your abdomen.

    01:44 Can you imagine how that would impact your quality of life.

    01:47 Your ability to drive your ability to walk your energy.

    01:51 This is a huge deal to the patient that's experiencing it.

    01:55 So while we may not see it very often when we do this requires the whole team to collaborate and help the patient deal with it.

    About the Lecture

    The lecture Therapeutic Paracentesis: Refractory Ascites (Nursing) by Rhonda Lawes is from the course Liver Cirrhosis (Nursing).

    Included Quiz Questions

    1. The client accumulates ascites after having a paracentesis
    2. The client's ascites decreases after furosemide treatment
    3. The client's ascites gradually decreases after maintaining a low sodium diet
    4. The client develops ascites a year after diuretic treatment and a paracentesis

    Author of lecture Therapeutic Paracentesis: Refractory Ascites (Nursing)

     Rhonda Lawes

    Rhonda Lawes

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