Question

You're caring for Jane, a 57 year old. patient with liver cirrhosis who developed ascites and requires paracentesis. Before her paracentesis, you instruct her to:

1. Empty her bladder.
2. Lie supine in bed.
3. Remain NPO for 4 hours.
4. Clean her bowels with an enema.

Answer 1

Jane, a 57-year-old with liver cirrhosis and ascites, should empty her bladder and lie supine in bed before paracentesis. Remaining NPO or cleaning bowels with an enema are not standard preparations for this procedure.

Step-by-step explanation:

The subject we're discussing is Jane, a 57-year-old patient with liver cirrhosis who developed ascites and requires a paracentesis.

Before undergoing paracentesis, Jane should be instructed to empty her bladder to decrease the risk of bladder injury during the procedure. This is due to the close proximity of the bladder to the area where fluid is removed. Additionally, Jane should lie supine in bed, as lying flat on her back allows the fluid in the abdomen to distribute evenly, making the procedure easier and safer.

The instructions to remain NPO (nothing by mouth) for 4 hours before the procedure, or cleaning her bowels with an enema, are not standard recommendations for paracentesis. The NPO status is typically required for procedures involving sedation or general anesthesia to reduce the risk of aspiration, while an enema is not a common prerequisite for paracentesis.