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ARTHROCENTESIS
ARTHROCENTESIS
Indications Patient with joint effusion Patient with Hemarthrosis Patient with suspected septic arthritis Patient with joint infection
Contraindications Overlying infection in the soft tissues Severe overlying dermatitis Bacteremia Uncooperative patient
Complications Infection Trauma Pain Joint instability Iatrogenic septic arthritis from lack of aseptic technique Damage to articular cartilage with the needle
Guidelines Assess the patient allergy to local anesthesia to be used Administer sedation if prescribed Make sure that the patient maintains the proper position throughout the procedure Ascertain that X-ray has been completed and consent from patient has been signed prior to procedure Refrain patient from moving the joints 24hours after the procedure Apply pressure dressing for 2-3 minutes after the procedure
Nursing Responsibilities : Before During After Advice the patient that he/she will on bed rest and x-ray will be obtained Record the total amount of fluid withdrawn from the procedure Monitor vital signs and watch closely for any complications Apply pressure for 2-3minutes Avoid moving for 5 to 24 hours after the procedure Position the patient comfortably with adequate support Reassure to support the patient during the procedure Expose the area and provide privacy Fill and arrange the specimen bottles accordingly Label each specimen bottle accordingly and send immediately to laboratory Check the Doctors Order Ascertain if consent has been signed Inform the patient that there is no diet/fluid restrict necessary prior to the test Teach or assist the patient with proper positioning Inform the patient about the nature of the procedure