Ascites Flashcards
ascites
excess accumulation of fluid in the peritoneal cavity; third spacing example
etiology
- cirrhosis + portal HTN
- R-sided HF
- severe changes in CHP or OP
- water/Na retention
how does cirrhosis + portal HTN causes ascites
non-functional fibrous tissue compresses vessels in the hepatic portal system leading to portal HTN –> inc in CHP in these vessels –> fluid shift occurs
how does R-sided HF cause ascites
R-sided HF causes congestion within R-side of heart and blood back up into systemic circuit. inc blood vol in vessels within abd organs –> inc CHP –> fluid shifts into interstitial spaces of abd organs –> abd organ distention –> fluid shifts into abd cavity = ascites
how do severe changes in CHP or OP cause ascites
- an inc in CHP or dec in OP –> ascites
- change in OP = proteinuria, fluid vol excess, liver failure
how does water/na retention cause ascites
water/na retention causes inc in blood vol –> inc CHP –> fluid shifts
mnfts
- dyspnea
- abdominal distention
why does dyspnea manifest
accumulation of fluid inc pressure within abd cavity –> impedes movement of diaphragm to inc vol of thoracic cavity to expand lungs
why does abdominal distention manifest
inc fluid in abd cavity results in distended abd
- pt lying flat has round abd and fluid on the side of abd
- pt stands up fluid flows downwards and abd rounded in lower region
tx
- small vol: diuretics and sodium restriction
- fluid and electrolytes
- large vol: paracentesis
why diuretics and sodium restriction used
- diuretics: to inc fluid loss to dec blood vol –> dec CHP in blood –> stop fluid from shifting from intravascular space into peritoneal space
- sodium restriction: dec blood vol (same action
paracentesis
involves aspirating fluid out of cavity w/ needle
