A client who has low back pain reports that they are unable to void. The nurse notices a distended bladder on assessment. Which of the following is the likely cause of this client's low back pain?

The correct answer is D. Urine output 75 mL in 1 hr.

Adequate urine output (at least 30 mL/hr) indicates effective hydration, showing that the kidneys are functioning properly and fluid balance is improving. A urine output of 75 mL in 1 hour suggests sufficient fluid replacement.

Here’s why the other options are incorrect:

• A. Urine specific gravity 1.005 to 1.030 – This range covers both normal and abnormal values. In dehydration, urine specific gravity is usually high (>1.030) due to concentrated urine. Effective treatment should lead to lower urine specific gravity, but the full range does not confirm improvement.

• B. Decreased pulse pressure – Pulse pressure is the difference between systolic and diastolic blood pressure. Dehydration typically causes a narrowed pulse pressure, so improvement should lead to a normal or increased pulse pressure rather than a decrease.

• C. Lightheadedness – Dizziness and lightheadedness are signs of dehydration-related hypotension. Effective hydration should resolve these symptoms, not maintain them.

Choice A reason: Proper hand hygiene is essential before connecting the tubing to the catheter to prevent infections, which is a key component of CAPD management.

Choice B reason: There is no requirement to lay down while the dialysis solution dwells in the peritoneal cavity. Patients can move around and continue with their daily activities.

Choice C reason: Regularly weighing oneself is important to monitor fluid balance and the effectiveness of the dialysis, making it a crucial part of home dialysis management.

Choice D reason: CAPD typically involves multiple exchanges throughout the day, not just one instillation at bedtime.

Choice E reason: Monitoring blood pressure is important for managing fluid balance and cardiovascular health in patients on dialysis.