A client with end stage liver disease, cirrhosis, and ascites is scheduled for a paracentesis. Which of the following interventions can be anticipated related to care of this patient?

Void prior to the paracentesis

Ask about family history of malignant hyperthermia.

Place the patient in the prone position for the procedure

Administer metronidazole prophylactically for infection

Answer and Explanation

The Correct Answer is A

A. Void prior to the paracentesis: Before a paracentesis, the patient is typically instructed to void to reduce the risk of puncturing the bladder during the procedure. It is an essential preparatory step.

B. Ask about family history of malignant hyperthermia: Malignant hyperthermia is related to anesthetic agents, not paracentesis.

C. Place the patient in the prone position for the procedure: The correct position for paracentesis is high Fowler’s (sitting upright at 45–90°) to allow fluid to collect in the lower abdomen for easier drainage.

D. Administer metronidazole prophylactically for infection: This is not a routine intervention before a paracentesis, as the risk of infection is managed with sterile technique during the procedure.

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Correct Answer is B

Explanation

peritonitis are present. Treating the underlying cause (perforation) is more urgent than lowering the fever.

B. Notify the healthcare provider: A hard, rigid abdomen with fever indicates possible perforation and peritonitis, which is a medical emergency. The provider must be notified immediately for urgent intervention.

C. Prepare to administer an enema: Enemas are contraindicated in acute diverticulitis due to the risk of perforation.

D. Continue to monitor the client closely: While continued monitoring is always necessary, immediate action (calling the provider) is critical when signs of peritonitis are present.

A. High fiber, low protein diet B. Prednisone to decrease inflammation C. Nasogastric tube to low intermittent suction D. Increase with meals and snacks

Correct Answer is C

Explanation

A. High fiber, low protein diet: A high-fiber diet is contraindicated during an acute episode of diverticulitis because it can exacerbate inflammation. Instead, a low-residue or clear-liquid diet is recommended.

B. Prednisone to decrease inflammation: While corticosteroids like prednisone are used for inflammatory conditions like IBD, they are not the first-line treatment for diverticulitis. Antibiotics and bowel rest are preferred.

C. Nasogastric tube to low intermittent suction: An NG tube is used to decompress the stomach and relieve bowel obstruction symptoms, such as bloating and cramping. This is appropriate if an obstruction is suspected.

D. Increase with meals and snacks: Increasing food intake is not recommended during an acute episode of diverticulitis. The client is typically placed on bowel rest or a clear liquid diet.

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A client with end stage liver disease, cirrhosis, and ascites is scheduled for a paracentesis. Which of the following interventions can be anticipated related to care of this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client diagnosed with acute diverticulitis is complaining of severe abdominal pain. On assessment, the nurse finds a hard, rigid abdomen and a temperature of 102 F. Which of the following is the highest priority?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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