Ascites: Causes, Clinical Manifestations, and Nursing Management

What is Ascites?

Ascites is the abnormal accumulation of protein-containing fluid within the peritoneal cavity. It is most commonly a complication of liver disease, but it can also be caused by heart failure, kidney failure, or certain types of cancer.

Common Causes

Portal Hypertension: Usually due to Liver Cirrhosis (80% of cases).

Heart Failure: Congestive heart failure leading to systemic congestion.

Hypoalbuminemia: Low levels of albumin (protein) in the blood, often due to nephrotic syndrome or malnutrition.

Malignancy: Cancers of the liver, pancreas, or ovaries.

Infections: Such as Tuberculosis peritonitis.

Clinical Manifestations (Symptoms)

Increased Abdominal Girth: The most common sign.

Rapid Weight Gain: Due to fluid accumulation.

Shortness of Breath (Dyspnea): Pressure on the diaphragm makes breathing difficult.

Everted Umbilicus: The belly button may push outward.

Abdominal Discomfort: A feeling of fullness or heaviness.

Shifting Dullness: A classic physical exam finding where the sound changes when the patient changes position.

Diagnostic Evaluation

Ultrasound: To confirm the presence and amount of fluid.

Paracentesis: Withdrawing fluid for analysis (Checking SAAG - Serum-Ascites Albumin Gradient).

CT Scan: To identify the underlying cause like tumors.

Management & Nursing Care

Sodium Restriction: A low-sodium diet (usually <2g per day) is the first line of treatment.

Diuretics: Medications like Spironolactone or Furosemide to help the body excrete excess fluid.

Daily Weight Monitoring: Essential for assessing the effectiveness of treatment.

Positioning: High-Fowler’s position to ease breathing.

Skin Care: The stretched skin on the abdomen is prone to breakdown and needs careful monitoring.

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Understand the pathophysiology, causes, and nursing management of Ascites. A complete guide for nursing students and healthcare professionals covering symptoms and treatment options.

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