Which of the following are important nursing considerations during a paracentesis procedure? Select all that apply

Paracentesis is a procedure used to remove excess fluid (ascites) from the peritoneal cavity, commonly performed in clients with conditions such as liver cirrhosis or malignancy. The procedure helps relieve abdominal pressure, improve breathing, and obtain fluid for diagnostic analysis. Nursing care focuses on ensuring client safety, preventing complications such as infection or bladder injury, and monitoring fluid balance before and after the procedure. Rationale: A. Assessing the abdominal site for skin integrity issues before puncture is important to reduce the risk of infection and complications. The nurse must ensure that the skin is intact, free from infection, and appropriately prepared for sterile needle insertion. This helps maintain aseptic technique and prevents peritoneal contamination. B. Administering routinely scheduled diuretics before the procedure is not appropriate. Diuretics may already be used in managing ascites, but they are not specifically required or beneficial immediately before paracentesis. The procedure itself removes fluid directly, making pre-procedure diuretic administration unnecessary for the intervention. C. Having the client void prior to the procedure is essential to reduce the risk of accidental bladder puncture during needle insertion. An empty bladder improves anatomical safety and allows better access to the peritoneal fluid collection. This is a standard pre-procedure safety measure in paracentesis care. D. Weighing the client before and after the procedure is important to evaluate the amount of fluid removed and assess fluid balance. Changes in body weight help determine the effectiveness of the procedure and guide ongoing management of ascites. It also assists in monitoring for potential fluid shifts or hypovolemia. E. Providing the client a heavy meal prior to the procedure is not appropriate because it may increase abdominal discomfort and pressure. Paracentesis is often performed on an empty or lightly fed stomach to improve comfort and reduce risk of complications. Heavy meals can also interfere with positioning and procedure tolerance.