A client with chronic kidney disease on peritoneal dialysis exhibits redness, tenderness, and drainage around the catheter site on the abdominal wall. While planning care, the nurse is most concerned about preventing which complication related to these findings?

Outflow obstruction.

Exit site infection.

Atelectasis

Peritonitis.

Answer and Explanation

The Correct Answer is B

B. Redness, tenderness, and drainage around the catheter site are classic signs of an exit site infection in peritoneal dialysis. Exit site infections are a common complication of peritoneal dialysis and can lead to more serious complications, such as peritonitis, if not promptly treated. Preventing exit site infections through proper catheter care and hygiene is essential in peritoneal dialysis management.
A. While outflow obstruction can occur in peritoneal dialysis, it typically presents with symptoms such as poor drainage of dialysate fluid, abdominal discomfort, and a decrease in dialysis efficiency. The described findings of redness, tenderness, and drainage around the catheter site are more indicative of a localized issue rather than outflow obstruction.
C. Atelectasis refers to the collapse of a part or the entire lung. While it can occur in hospitalized patients, especially those with underlying respiratory conditions, the described findings are not indicative of atelectasis. Atelectasis typically presents with symptoms such as dyspnea, cough, and decreased breath sounds on auscultation.
D. Peritonitis is a severe complication of peritoneal dialysis characterized by inflammation and infection of the peritoneal lining. While redness, tenderness, and drainage around the catheter site may precede peritonitis, the focus of concern in this scenario is primarily on preventing exit site infection, which, if left untreated, can progress to peritonitis.

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Correct Answer is C

Explanation

C. Breakthrough pain is a transient exacerbation of pain that occurs despite the use of around- the-clock analgesics for persistent pain. Breakthrough pain episodes require rapid intervention with additional analgesics or adjustments to the current pain management regimen to provide adequate pain relief and improve the client's quality of life.
A. Replacing transdermal analgesic patches every 72 hours is important for ensuring consistent delivery of medication, but it is not directly related to addressing breakthrough pain.
B. Administering analgesics on a fixed and continuous schedule is important for maintaining baseline pain control, but it may not address breakthrough pain adequately.
D. Frequently evaluating the client's pain is essential, but monitoring specifically for breakthrough pain ensures timely intervention when pain exacerbations occur.

A. Determine which prescription will have the quickest onset of action. B. Compare the client's pain scale rating with the prescribed dosing. C. Document the client's report of pain in the electronic medical record. D. Ask the client to choose which medication is needed for the pain.

Correct Answer is B

Explanation

B. Comparing the client's pain scale rating with the prescribed dosing ensures that the nurse selects the appropriate medication and dosage based on the severity of the client's pain. This action helps ensure safe and effective pain management by matching the intensity of the client's pain with the appropriate analgesic medication and dose.
A. Although this may be relevant in some situations, particularly if the client's pain requires rapid relief, the nurse should prioritize selecting the medication and dose based on the severity of the client's pain rather than solely on the onset of action.
C. The process does not address the immediate need to select the appropriate analgesic medication for the client's pain.
D. This may not be appropriate, especially if the client is in pain or unable to make an informed decision about which medication to choose.

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A client with chronic kidney disease on peritoneal dialysis exhibits redness, tenderness, and drainage around the catheter site on the abdominal wall. While planning care, the nurse is most concerned about preventing which complication related to these findings?

Nursing Test Bank

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