Background: Paracentesis is more frequently used as a diagnostic tool to examine ascetic fluid and may be used as a therapeutic to remove a significant amount of fluid that is causing discomfort or difficulty breathing or that is affecting how the kidneys or intestines (bowel) are working into the abdomen to remove and drain ascetic fluid from the peritoneal cavity. This study aimed to determine the effect of instructional guidelines based on short message service on nursing performance regarding paracentesis for cirrhotic patients and to assess patients' complications after instructional guidelines based on short message service application. Design: Quasi-experimental research design was used to complete this study. Setting: The study was carried out at the internal medicine unit at Damanhur national medical institute Hospital, Egypt. Subjects: A convenient sampling technique involving 50 nurses and 100 patients divided into two groups (study group and control group), 50 for each group. Tool: A self-administered questionnaire (pre and post-test format) to assess the following parts (I) nurse's personal characteristics; (II) Nurse's knowledge about paracentesis (pre and post-test format); (III): Observational checklist about paracentesis procedure; and (IV): Patients' complications assessment sheet. Results: a good improvement in the knowledge and practice scores were found after instructional guidelines based on short message service application with a statistically significant difference and the complications of paracentesis were lesser among study group patients than in the control group. Also, there was a highly significant correlation between demographic characteristics and nurses' level of knowledge and practice in pre- and post-instructional guidelines mainly in the items of gender, and educational qualification. While there was a highly significant correlation between demographic characteristics and nurses' level of knowledge in pre- and post-instructional guidelines with nurses' age.  Conclusion: patients undergoing paracentesis are exposed to several complications. Improving nursing guidelines can favorably affect the incidence of these complications. Recommendation: Continuous training programs to improve Nurse's knowledge and practices which will reflect on their patients' care.