Edication

2. 2
Sadaf rehman ,CON ,CH & UCHS,
LHR

3.  Sadaf Rehman
 Sadia
 Mehwish Hanif
 Iqra Manzoor
 Rida Riaz
 Mubarrah
 Sadia Manzoor
 Sadia Bibi
 Minahil Ibrahim
 Mehwish Khan

5.  PARACENTESIS IS THE REMOVAL OF FLUID
FROM THE ABDOMINAL CAVITY(PERITONIUM)
TO REDUCE INTRA-ABDOMINAL TENSION IN
PATIENT WITH RESPIRTORY COMPROMISE
AND TENSION ASCITES OR OBTAIN FLUID FOR
CULTURE.
 IT IS ALSO CALLED PERITONEAL TAP

6.  ABDOMINAL PARACENTESIS IS THE
PUNCTURE OF THE ABDOMINAL WALL
WITH THE AN ABDOMINAL TROCHAR AND
CANNULA

8.  TO RELIEVE PRESSURE ON THE ABDOMINAL
AND CHEST ORGANS DUE TO ASCITES
 TO STUDY CHEMICAL,BACTERIOLOGICAL
AND CELLULAR COMPOSITION OF
PERITONEAL FLUID FOR DIAGNOSIS OF
DISEASE
 TO DRAIN EXUDATE IN PERITONITIS

9.  TO PREPARE FOR PROCEDURES LIKE
PERITONEAL DIALYSIS
 TO STUDY CELL COUNT,GRAM
STAIN,MICROSCOPY AND CULTURE
 TO REMOVE FLUID AND INSTILL AIR
 TO CREATE ARTIFICAL PNEUMOPERITONEUM
AS TREATED FOR PULMONARY
TUBERCULOSIS AFFECTING BASE OF LUNG.

10.  Pregnancy
 Distended urinary bladder
 Abdominal-wall cellulitis
 Distended bowel
 Intra-abdominal adhesions

11.  The two recommended areas
of abdominal wall entry for
paracentesis are as follows.
 2 cm below the umbilicus in
the midline (through the linea
alba)
 -5 cm superior and medial to
the anterior superior iliac
spines on either side(in
update 3cm)

13.  A STERILE TRAY CONTAINING:
 SPONGE HOLDING FORCEPS
 05 ML SYRINGE
 20 ML SYRINGE
 BETADINE SOLUTION

15.  STERILE GLOVES
 THREE WAY ADAPTER( TROCAR)
AND TUBING
 SMALL BOWLS
 SPECIMEN BOTTLE
 STERILE DRESSING PACK
 COTTON BALLS
 LOCAL ANESTHETICS
 SPHYGMOMANOMETER

16.  PREPROCEDURAL STEPS
 IDENTIFY THE PATIENT AND EXPLAIN THE
PROCEDURE TO THE PATIENT AND
RELATIVES
 MEASURE ABDOMOINAL GIRTH AND WEIGHT
OF THE PATIENT
 OBTAIN INFORMED CONSENT
 PLACE THE PATIENT IN UPRIGHT POSITION

17.  ASK THE PATIENT TO CATHETERISE
 FOLLOW STRICT ASEPTIC TECHNIQUES
 PLACE THE SCREEN
 PREPARE THE SKIN FROM NIPPLE TO PELVIS
 RECORD VITAL SIGNS
 KEEP THE PATIENT WARM AND COMFORTABLE
 KEEP DRUGS AND EQUIPMENTS READY TO
TREAT SHOCK
 PLACE SPHYGMOMANOMETER CUFF AROUND
PATIENT’S ARM

18.  EXPOSE THE AREA BELOW THE NIPPLE TO
THE PUBIC AREA TO MINIMIZE EXPOSURE OF
THE PATIENT
 PLACE THE PATIENT IN SUPINE OR SITTING
POSITION
 PLACE THE MACKINTOSH
 WASH HANDS AND OPEN THE STERILE FIELD

19.  ASSIST THE PHYSICIAN IN INSERTING THE
TROCAR AND CANNULA BELOW THE UMBILICUS.
 REMOVE THE TOCAR
 PLACE THE RUBBER TUBING INTO A STERILE
PINT ,MEASURE AND ADJUST THE RATE OF FLOW
WITH A SCREW CLAMP TO MEASURE THE
DRAINED OUT FLUID AND PREVENT CROSS
INJECTION
 AFTER ENOUGH FLUID IS WITHDRAWN , REMOVE
THE CANNULA
 PLACE STERILE DRESSING AND PRESSURE
BANDAGE OVER THE PUNCTURE SITE
 PLACE THE PATIENT IN COMFORTABLE POSITION

23.  TIDY UP THE UNIT AFTER MAKING THE PATIENT
COMFORTABLE
 RECORD THE AMOUNT OF FLUID REMOVED AND
ITS CHARACTERISTICS TO MEASURE
ACCURATELY
 CHECK THE VITAL SIGNS
 OBSERVE THE DRESSING
 ASESS FOR HYPOVOLEMIA CHANGES IN
MENTAL STATUS

24. Post-paracentesis circulatory dysfunction
 Hypotension
 Hyponatremia
 Renal failure
 Shortened survival

25.  Localized infection
 Abdominal wall hematoma
 Persistent ascites fluid leak
 Hemorrhage
 Intra-abdominal organ injury
 Inferior epigastric artery puncture

26.  Pentoneal dialysis is the process cavity acts as
reservoir for the dialysate and peritoneum
serves as semi-permeable membrane, across
which excess body fluids and solutes,
including uremic toxins are removed
 Peritoneal membrane is in contact with rich
blood supply to the abdominal organs and
dulysate is infused into peritoneal cavity via
catheter.