CLINICAL DO'S & DON'TS: Assessing for ascites

February 2005 
Volume 35  Number 2
Pages 68 - 68
  PDF Version Available!


  • DO

  • Assessing for shifting dullness:

  • Assessing for fluid wave:

  • DON'T



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    A DISTENDED ABDOMEN, bulging flanks, and a protruding, displaced umbilicus are signs of ascites, free fluid in the peritoneal cavity. Cirrhosis, heart failure, renal failure, portal hypertension, chronic hepatitis, and cancer are common causes. Shifting dullness and a fluid wave indicate ascites.


    * Provide privacy, explain the procedure to the patient, and perform hand hygiene.

    * Place him supine and inspect his abdomen for distension. Observe for bulging flanks caused by ascites fluid sinking with gravity. (Gas-filled bowel loops rise to the surface.) Look for shiny, taut skin and prominent veins and assess ...

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