[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Medical–surgical nursing](https://durgical.com/en/nursing/areas/med-surg/) › Assisting paracentesis: before, during and after # Assisting paracentesis: before, during and after - Procedure Paracentesis drains ascitic fluid with a needle: the nurse prepares, keeps the field sterile, watches blood pressure and the site, and records the fluid. Updated Nov 13, 2026 ## Key points - Informed consent comes first, for both diagnostic and therapeutic taps. - Ultrasound guidance, when available, lowers complications. - Routine clotting tests and blood products before the tap are not recommended. - Large-volume drainage can drop the blood pressure and harm the kidneys: the team prescribes albumin according to the volume removed. - Inoculate blood-culture bottles with ascitic fluid at the bedside when ordered: it helps find the organism. - A leak from the site: lie the patient on the opposite side and apply the dressing the protocol says. ## What it is Paracentesis is the insertion of a needle or cannula through the abdominal wall to remove ascitic fluid, either a small sample for tests (diagnostic) or a large volume to relieve tension, pain or breathlessness (therapeutic). The clinician performs it, often with ultrasound; the nurse checks consent and orders, prepares the patient and the equipment, keeps the technique aseptic, monitors the patient while fluid drains, handles the samples and watches the site and the circulation afterwards. ## Indications - Diagnostic tap: every new ascites, and every admitted patient with cirrhosis and ascites, to look for infection. - Also when the patient with ascites has GI bleeding, shock, fever, encephalopathy, or worsening liver or kidney function. - Therapeutic tap: tense ascites causing pain or breathlessness. ## Contraindications and precautions - Confirm consent and the orders (type of tap, tests, albumin). - Ask about allergies (medicines, local anaesthetic), all medicines including herbal remedies, bleeding problems and possible pregnancy. - Bleeding risk is higher with advanced liver disease and kidney impairment; tell the clinician. - The needle can puncture the bowel, bladder or a vessel: the clinician chooses the site, usually away from the midline vessels. - Aseptic technique throughout: the puncture opens a path into the peritoneum. ## Equipment - Sterile paracentesis set (needle or cannula, syringes) and sterile gloves and drape. - Skin antiseptic and local anaesthetic. - Labelled specimen tubes and blood-culture bottles, as ordered. - Drainage bag or containers, and a sterile dressing. - Ultrasound, when available; blood pressure monitor. ## Step by step (and why) - Check identity, consent and the orders — wrong or missing tests mean another puncture. - Ask about allergies, medicines and bleeding problems; ask the patient to void if the protocol says — a full bladder is at risk. - Take baseline vital signs — they are the reference for hypotension during and after drainage. - Position and support the patient as the clinician asks — a steady patient makes the puncture safer. - Assist with aseptic technique: skin antisepsis, sterile field, local anaesthetic — the puncture can cause infection. - Label samples at the bedside and inoculate culture bottles if ordered — bedside inoculation improves detection. - While it drains (often 1 to 4 hours), watch blood pressure, pulse, dizziness and pain — large drainage lowers pressure. - Record the total volume and the look of the fluid, and give albumin as prescribed — the team doses it by volume. - Apply the dressing and check for leaking; if it leaks, lie the patient on the opposite side per protocol. - Repeat vital signs and site checks as the protocol says and document — late bleeding and hypotension occur. ## Complications - Bleeding at the site or into the abdomen, more likely with advanced liver disease and kidney injury. - Persistent leak of ascitic fluid from the puncture. - Puncture of the bowel, bladder or a blood vessel. - Low blood pressure and kidney injury after large-volume drainage. - Infection. ## Next step: when to call for help - Call for falling blood pressure, rising pulse, dizziness or fainting during or after drainage. - Call for increasing abdominal pain, a rigid abdomen or fever. - Call for bleeding through the dressing or bloody fluid in the drain. - Call if urine output falls after a large-volume tap. - Report a leak that continues despite positioning and dressing. ## Test yourself Think of the answer, then tap the question to see it. ## Who needs a diagnostic paracentesis on admission? Every patient admitted with cirrhosis and ascites, to look for infection of the fluid, and anyone with new ascites. ## Are clotting tests and blood products routinely needed before a tap? No. The guideline does not recommend them routinely; the clinician weighs bleeding risk, which is higher with advanced liver disease and kidney injury. ## Why is albumin given after a large-volume paracentesis? Removing a large volume can drop the blood pressure and harm the kidneys; albumin, prescribed according to the volume removed, reduces that risk. ## What do you do if ascitic fluid keeps leaking from the site? Lie the patient on the opposite side and apply the dressing the protocol says; report it if the leak continues. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/assisting-paracentesis-before-during-and-after/) ## Connections ## Related 2 - [Cirrhosis: ascites, weight and girth, encephalopathy, variceal bleeding and the skin](https://durgical.com/en/nursing/cirrhosis-ascites-weight-and-girth-encephalopathy-variceal-bleeding-and-the-skin/) - [Clean and sterile technique: medical and surgical asepsis](https://durgical.com/en/nursing/clean-and-sterile-technique-medical-and-surgical-asepsis/) ## Related conditions 2 - [Cirrhosis](https://durgical.com/en/conditions/cirrhosis/) - [Ascites and spontaneous bacterial peritonitis](https://durgical.com/en/conditions/ascites-and-spontaneous-bacterial-peritonitis/) [← All of nursing](https://durgical.com/en/nursing/) Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order. Sources: [Guidelines on the management of ascites in cirrhosis](https://pmc.ncbi.nlm.nih.gov/articles/PMC7788190/) (Gut, British Society of Gastroenterology and British Association for the Study of the Liver (open access, PMC), 2021); [Paracentesis (abdominal tap)](https://medlineplus.gov/ency/article/003896.htm) (MedlinePlus, U.S. National Library of Medicine, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/nursing/assisting-paracentesis-before-during-and-after/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/assisting-paracentesis-before-during-and-after/