A client is diagnosed with chronic kidney disease, stage 5. The nurse knows at this stage the client will have to include which of the following in their treatment that has not been needed in previous stages?

Step 1 is to calculate the number of hours it will take to infuse 1000 mL at a rate of 200 mL per hour.

Step 2 is to divide the total volume by the rate of infusion:

1000 mL ÷ 200 mL/hr

Step 3 is to perform the division:

1000 ÷ 200 = 5

Result: 5 hours

Choice a reason: The patient uses clean technique when instilling the dialysate is incorrect and requires additional teaching. Peritoneal dialysis requires sterile technique to prevent infection. Using a clean technique, which is less rigorous than sterile technique, increases the risk of introducing pathogens into the peritoneal cavity. Proper sterile technique involves meticulous hand hygiene, using sterile gloves, and ensuring all equipment and supplies are sterile.
Choice b reason: The patient performs exchanges on a table with a sterile drape is appropriate. Using a sterile drape helps maintain a sterile field and reduces the risk of contamination during the dialysis procedure. This practice is an important part of sterile technique and helps ensure the patient's safety.
Choice c reason: The patient verbally expresses symptoms to report to the HCP is a positive behavior. Being aware of and communicating symptoms that may indicate complications, such as signs of infection or peritonitis, is crucial for timely intervention and management. This practice shows the patient is knowledgeable about monitoring their health and knowing when to seek professional help.
Choice d reason: The patient washes their hands before beginning is an essential step in both clean and sterile techniques. Proper hand hygiene is critical in preventing the spread of infection and is a fundamental practice in peritoneal dialysis. Washing hands thoroughly before starting the procedure helps minimize the risk of contamination.