A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which condition entered on the client's medical record should the nurse recognize as a contraindication for peritoneal dialysis?

A. Minimize symptoms by wearing loose, comfortable clothing:
This is the correct answer. Wearing loose, comfortable clothing can help alleviate pressure on the abdomen, reducing the likelihood of exacerbating GERD symptoms.

B. Sleep without pillows at night to maintain neck alignment:
This recommendation is not specifically related to GERD. In fact, elevating the head of the bed or using extra pillows can be helpful in preventing acid reflux during sleep.

C. Adjust food intake to three full meals per day and no snacks:
It is generally recommended for individuals with GERD to have smaller, more frequent meals rather than three large meals. Eating smaller portions can help reduce the likelihood of gastric distention and reflux.

D. Avoid participation in any aerobic exercise programs:
Exercise is generally beneficial for overall health, but intense aerobic exercise immediately after eating may contribute to GERD symptoms. However, this does not mean avoiding all aerobic exercise. It is more appropriate to advise against vigorous exercise immediately after meals.

A. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules.
Hyperaldosteronism is characterized by an excess of aldosterone, a hormone that regulates sodium and water balance. In cirrhosis, however, sodium retention is often related to other mechanisms such as portal hypertension and hypoalbuminemia, rather than hyperaldosteronism.

B. Decreased renin-angiotensin response related to an increase in renal blood flow.
Cirrhosis is more commonly associated with an activated renin-angiotensin-aldosterone system, leading to increased sodium and water retention. The increased renin-angiotensin response is a compensatory mechanism to maintain perfusion in the setting of cirrhosis and does not contribute to decreased renal blood flow.

C. Decreased portacaval pressure with greater collateral circulation.
This statement is not accurate. In cirrhosis, there is typically increased portacaval pressure due to portal hypertension, which can lead to the development of collateral circulation. However, this does not explain the edema and ascites seen in cirrhosis.

D. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
This is the correct choice. In cirrhosis, liver damage leads to decreased synthesis of albumin. Albumin plays a crucial role in maintaining colloidal oncotic pressure, and when it is decreased (hypoalbuminemia), fluid is more likely to leak out of blood vessels, resulting in edema. The same mechanism contributes to the development of ascites in the abdominal cavity.