The nurse is caring for a patient with alcoholic liver cirrhosis complicated by abdominal ascites. A diagnostic paracentesis is performed. Shortly after the procedure, the patient becomes hypotensive and quickly loses consciousness. On exam, the patient is pale, peripheral pulses are faint, and extremities are cool to the touch. Which of the following is the most likely etiology of this patient’s condition?

Question

The nurse is caring for a patient with alcoholic liver cirrhosis complicated by abdominal ascites.  A diagnostic paracentesis is performed.  Shortly after the procedure, the patient becomes hypotensive and quickly loses consciousness.  On exam, the patient is pale, peripheral pulses are faint, and extremities are cool to the touch.   Which of the following is the most likely etiology of this patient&rsquo;s condition?

Accepted Answer

Laceration of a major artery resulting in massive intraabdominal bleeding. Complications following abdominal paracentesis includes laceration of a vessel with the catheter tip.  Rupture of a major vessel would result in massive intraabdominal bleeding following the procedure, quickly resulting in hypotension and profound hemorrhagic shock.  Peritonitis, either chemical or infectious, would result in septic shock which would present with fever and &ldquo;warm&rdquo; hypotension.  Cardiac arrhythmia is a rare complication of this procedure and would more likely present with cardiac signs.

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