A nurse is caring for a client on peritoneal dialysis who complains of cloudy drainage from the catheter site. Which of the following actions should the nurse take first?
Administer an antibiotic for potential infection.
Measure the client's vital signs and assess for pain.
Clamp the catheter and notify the healthcare provider.
Obtain a sample of the drainage for culture and sensitivity testing.
The Correct Answer is D
A) This statement is incorrect. While administering an antibiotic may be necessary if peritonitis is confirmed, it should not be done without obtaining a sample for testing first.
B) This statement is incorrect. Measuring vital signs and assessing for pain are essential aspects of client assessment, but they may not provide enough information to determine the cause of the cloudy drainage.
C) This statement is incorrect. Clamping the catheter may be necessary if peritonitis is suspected, but it should not be done without first obtaining a sample of the drainage for testing.
D) This statement is accurate. Cloudy drainage from the catheter site may indicate peritonitis, which is an infection of the peritoneal cavity. Obtaining a sample of the drainage for culture and sensitivity testing can help identify the presence of infection and guide appropriate treatment.
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Related Questions
Correct Answer is B
Explanation
A. Incorrect. Warming the dialysate fluid to body temperature before instilling it into the peritoneal cavity is a standard procedure in continuous ambulatory peritoneal dialysis (CAPD. .
B. Correct. Performing the exchanges in a clean, dry environment free from pets is crucial to prevent contamination and reduce the risk of infection during CAPD.
C. Incorrect. Using tap water to cleanse the catheter insertion site before the exchange is not recommended. The catheter exit site should be cleaned with an appropriate antiseptic solution as instructed by the healthcare provider.
D. Incorrect. While daily dressing changes are important, using sterile technique for catheter dressing changes may not be necessary, as the dressing does not directly contact the peritoneal cavity during CAPD exchanges.
Correct Answer is C
Explanation
A. Incorrect. Using sterile technique when handling the catheter is essential to prevent infection. Clients and caregivers should be taught the proper aseptic technique for catheter care.
B. Incorrect. Alcohol wipes can dry out the skin and are not recommended for cleaning the catheter insertion site. A more appropriate solution is provided in the correct answer.
C. Correct. Changing the dressing over the catheter daily using clean gloves helps maintain a clean and dry site, reducing the risk of infection during peritoneal dialysis.
D. Incorrect. The catheter should not be immersed in water during bathing or showering, as this can introduce pathogens and increase the risk of infection.
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