Question

l. What assessment findings indicate ascites?

n. What are the advantages of using the indwelling peritoneal catheter?

o. What teaching information would you include for a patient being discharged with an Aspira drain?

You are making a home visit to a patient with MA and an Aspira drain. What would you do if: • The patient reports increasing dyspnea and abdominal distention? • The patient tells you that she drains 3-4 liters from her abdomen every 4 days? • The patient has a low-grade fever?

Answer 1

Question 1 Answer.

Ascites is the abnormal building up of fluid within the abdomen,if more than 25 ml of fluid in the peritoneal cavity.

Assessment finding of ascites include:

1. Once the peritoneal fluid become more than 500ml, ascites may be assessed by the presence of shifting dullness or bulging flanks.

2. Elevated jugular venous pressure is suggestive of cardiac origin of ascites.

3. There will be tympany sound on percussion over airfilled bowel and dullness over fluid filled areas. If ascites present fluid shift downwards,so we can hear tympany at first,then dullness over fluid filled area.

4. In the case of ascites ther will be marked increase in amdominal size, increased weight, abdominal discomfort and shortness of breath.

5. A patient can identify ascites by a feeling of fullness, a ballooning belly and rapid weight gain.

6. Fluid wave: in the case of ascites the examiner can detect a shock wave of fluid moving against the fingertips pressed along the flank,as the fluid is shifting from one side to other side of abdomen by the force of tap.