A client on peritoneal dialysis is experiencing abdominal pain and fever. Which of the following actions should the nurse take first?

A) This statement is incorrect. Hypermagnesemia (elevated magnesium levels) can be a concern in ESRD, but it is not a primary indication for initiating dialysis. Magnesium levels can be managed through dietary restrictions and medications without the need for dialysis.

B) This statement is incorrect. Hyperphosphatemia (elevated phosphorus levels) is a common issue in ESRD, but it is not a primary indication for initiating dialysis. Clients with ESRD may receive phosphate binders to control phosphorus levels without necessarily needing immediate dialysis.

C) This statement is incorrect. Hyperkalemia (elevated potassium levels) is a concern in ESRD, but it is not the primary indication described in the scenario. While hyperkalemia may occur with fluid overload, the primary concern in this case is the hypervolemia and its associated symptoms.

D) Hypervolemia (severe fluid overload) is a critical indication for initiating dialysis in clients with end-stage renal disease. Dialysis helps remove excess fluid from the body and can relieve symptoms such as pulmonary edema and hypertension.

A. Incorrect. Increasing the dialysate temperature can lead to vasodilation and potentially exacerbate hypotension during dialysis.

B. Correct. Limiting fluid removal during dialysis is essential to prevent excessive fluid loss, which can cause hypotension and potentially lead to intradialytic hypotension.

C. Incorrect. Encouraging a high-sodium diet is not the primary intervention to prevent dialysis-related hypotension. It may be recommended for some clients to manage hyponatremia, but fluid management is more critical.

D. Incorrect. Administering intravenous hypertonic saline during dialysis is not a routine intervention to prevent hypotension. It may be used in specific cases, but fluid management is the primary approach.