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A nurse is admitting a client who is to undergo paracentesis for removal of ascitic fluid. Which of the following actions should the nurse take?

A.

Place the client in a side-lying position for the procedure.

B.

Administer a low-volume hypertonic enema the night before the procedure.

C.

Weigh the client before and after the procedure.

D.

Ensure the client has a full bladder just prior to the procedure.

Answer and Explanation

The Correct Answer is C

A. Place the client in a side-lying position for the procedure. Paracentesis is typically performed with the client in a high-Fowler’s or upright position, allowing fluid to collect in the lower abdomen for easier drainage.
B. Administer a low-volume hypertonic enema the night before the procedure. An enema is not required for a paracentesis, as the procedure involves the peritoneal cavity, not the bowel.
C. Weigh the client before and after the procedure. Weighing the client helps assess the amount of fluid removed and monitor for fluid shifts. It is a key part of pre- and post-procedural care to evaluate the effectiveness of the intervention.
D. Ensure the client has a full bladder just prior to the procedure. A full bladder increases the risk of injury during needle insertion. The bladder should be emptied before the procedure to prevent accidental puncture.
 


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Related Questions

Correct Answer is ["200"]

Explanation

Total volume to infuse = 100 mL

Infusion time = 30 minutes

  • Convert infusion time to hours:

1hr = 60 minutes

30 minutes / 60 minutes/hour = 0.5 hours

  • Calculate the infusion rate in mL per hour:

Infusion rate (mL/hr) = Total volume (mL) / Infusion time (hours)

= 100 mL / 0.5 hours

= 200 mL/hr

Correct Answer is C

Explanation

A. An angiocatheter. This is used for peripheral IV access, not for accessing implanted venous ports. It is not designed to penetrate the septum of a port safely or effectively.
B. A 25-gauge needle. This needle is too small and not suitable for accessing a venous port, as it may not deliver adequate flow and can damage the port's septum.
C. A noncoring needle. Also known as a Huber needle, this is the correct choice for accessing an implanted port. It has a deflected tip that prevents coring (removing pieces of the port’s septum), preserving the integrity of the port and reducing the risk of damage or infection.
D. A butterfly needle. These are typically used for short-term venous access or blood draws and are not appropriate for accessing an implanted port. They lack the design necessary to protect the septum of the device.

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