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What is the main pharmacological concern after performing a paracentesis?

A.

Tachycardia

B.

Hyperglycemia

C.

Bowel Changes

D.

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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Related Questions

Correct Answer is []

Explanation

Rationale:

  • Potential Condition: The client with acute pancreatitis developed positive Chvostek and Trousseau signs, both classic indicators of hypocalcemia. Pancreatitis often causes calcium to bind to necrotic fat (saponification), lowering serum calcium.
  • Actions to Take:
    • Increasing IV fluids may be prescribed to improve intravascular volume and help stabilize electrolytes.
    • Requesting a STAT ECG is essential because hypocalcemia can prolong the QT interval and predispose to life-threatening arrhythmias.
  • Parameters to Monitor:
    • Intake and output helps assess hydration status, especially with diarrhea and ongoing fluid/electrolyte losses.
    • Bowel sounds should be monitored because hypocalcemia may cause abdominal cramping and changes in GI motility.

Correct Answer is C

Explanation

Rationale:
A. 59% dextrose in lactated Ringer’s is not a standard solution and would be hypertonic and unsafe.
B. 0.45% sodium chloride does not provide the glucose necessary to prevent hypoglycemia.
C. 10% dextrose in water (D10W) is correct. If TPN runs out, a dextrose-containing solution should be administered to prevent hypoglycemia until the next TPN bag is available.
D. Lactated Ringer’s does not provide sufficient glucose to maintain blood sugar during TPN interruption.

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