What is the main pharmacological concern after performing a paracentesis?

Tachycardia

Hyperglycemia

Bowel Changes

Hypotension

Answer and Explanation

The Correct Answer is D

Rationale:

A. Tachycardia may occur secondary to hypotension, but it is a secondary concern, not the primary pharmacological issue.

B. Paracentesis does not directly affect blood glucose levels.

C. While changes in bowel habits may occur with fluid shifts, they are not the primary concern after paracentesis.

D. Removal of large volumes of ascitic fluid can lead to intravascular volume depletion, resulting in hypotension. Monitoring blood pressure before, during, and after the procedure is essential, and volume replacement may be required to maintain hemodynamic stability.

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Correct Answer is C

Explanation

Rationale:
A. Pain assessment is important but not the immediate priority following an EGD. Discomfort is expected after the procedure, yet it does not pose the greatest risk to airway safety.

B. Nausea should be monitored, especially since sedation and irritation of the upper GI tract can cause vomiting, but this is not the most critical concern immediately after the procedure.

C. The gag reflex must be assessed first because topical anesthetics used during the EGD suppress the swallowing and protective airway reflexes. If oral fluids or food are given before the gag reflex returns, the client is at high risk for aspiration, which can lead to pneumonia or airway obstruction. Ensuring the gag reflex has returned is the priority safety measure before advancing the diet or giving oral medications.

D. Level of consciousness should also be assessed, since sedatives are commonly used during the procedure. However, the risk of aspiration from an absent gag reflex presents a more immediate threat to life and therefore takes priority.

A. Change the TPN tubing every 48 hr B. Allow 18 hr for the lipids to infuse when not mixed with the TPN solution. C. Use a 1.2 micron filter when infusing TPN with fat emulsions added. D. Change the TPN solution after 36 hr.

Correct Answer is C

Explanation

Rationale:

A. The tubing for TPN must be changed every 24 hr (not 48 hr) to reduce the risk of central line–associated bloodstream infection (CLABSI).

B. Lipid emulsions should not hang for more than 12 hr to prevent bacterial growth and infection.

C. A 1.2-micron filter is required for TPN that contains lipids to remove particulate matter, bacteria, and fungi, since lipid solutions cannot pass through smaller filters.

D. TPN solutions should be changed every 24 hr (not 36 hr) to reduce infection risk.

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What is the main pharmacological concern after performing a paracentesis?

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