A nurse is planning care for a client who is scheduled to have a paracentesis. Which of the following actions should the nurse include in the plan of care?
Explanation & Rationale
A) Administer 1 L dextrose 5% in water IV bolus prior to the procedure: Administering a large volume IV bolus is generally unnecessary before a paracentesis. It can lead to abdominal distension and discomfort, potentially complicating the procedure. Fluid management should be carefully considered based on the client’s condition rather than a standard bolus. B) Initiate NPO status 4 hr prior to the procedure: Paracentesis typically does not require NPO status unless sedation is planned, which is uncommon. Keeping the client NPO can cause unnecessary discomfort and does not align with standard pre-procedural care for a paracentesis, which usually allows for regular oral intake. C) Position the client over an overbed table prior to the procedure: While positioning is crucial for comfort and access, clients are generally positioned sitting at the edge of the bed or in a semi-Fowler's position. An overbed table may not provide adequate support and could lead to discomfort or complications during the procedure. D) Instruct the client to empty her bladder prior to the procedure: This action is important as it helps reduce the risk of bladder injury during the paracentesis and minimizes discomfort. An empty bladder allows for better access to the abdominal cavity, indicating that the nurse understands the necessary preparations for the procedure.