A nurse is caring for a client who has end-stage liver disease and is undergoing a paracentesis. Which of the following actions should the nurse take to evaluate the effectiveness of the procedure?
Confirm that the client is able to urinate.
Compare the client's current weight with preprocedure weight.
Examine for leakage at the site of the procedure.
Check the client's serum albumin levels.
The Correct Answer is B
A. While urine output is important, it is not the most direct indicator of the success of a paracentesis.
B. Comparing the client's weight before and after the procedure helps to evaluate the effectiveness by showing a reduction in fluid buildup.
C. Leakage at the site could indicate a complication, but it is not the primary measure of the procedure’s
effectiveness.
D. Serum albumin levels may be monitored but are not the first indicator of success after a paracentesis.
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Related Questions
Correct Answer is B
Explanation
A. Postural drainage should ideally be done after meals to reduce the risk of vomiting.
B. Holding the hand flat during percussions helps distribute the force evenly and prevents injury to the
child’s ribcage.
C. The procedure may need to be performed more than twice daily, depending on the child's condition.
D. A bronchodilator is typically administered before the procedure, not after, to help open the airways and improve the effectiveness of drainage.
Correct Answer is C
Explanation
A. Creatinine clearance is used to assess kidney function, not related to petechiae or ecchymoses.
B. Potassium levels are important for assessing electrolyte balance but are not directly related to petechiae or ecchymoses.
C. Petechiae and ecchymoses are signs of bleeding, often due to a low platelet count, so this test is appropriate.
D. Prealbumin is a protein marker for nutrition, not directly related to bleeding or clotting issues.
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