A nurse is changing the dressing for a client who is receiving peritoneal dialysis. Which of the following actions should the nurse take?

Place a mask on the client during the procedure

Cleanse the catheter site using a side-to-side motion.

Tape down the corners of the dressing

Secure an occlusive dressing over the gauze pads.

Answer and Explanation

The Correct Answer is A

A. Place a mask on the client during the procedure: A mask should be placed on the client to reduce the risk of infection during the dressing change. Peritoneal dialysis involves accessing the peritoneal cavity, and maintaining a sterile environment is crucial to prevent contamination.

B. Cleanse the catheter site using a side-to-side motion: The catheter site should be cleansed using a circular motion starting from the site of insertion and moving outward. This helps avoid introducing bacteria into the insertion site. Side-to-side motion may push bacteria into the area.

C. Tape down the corners of the dressing: While securing the dressing is important, taping the corners may not provide the optimal seal and could risk introducing contaminants. The dressing should be secured properly, but not necessarily with just tape at the corners.

D. Secure an occlusive dressing over the gauze pads: An occlusive dressing over gauze pads is not ideal for peritoneal dialysis catheters. A sterile, breathable dressing is recommended to allow for proper airflow and prevent moisture accumulation, which can promote infection.

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Correct Answer is C

Explanation

A. "I had symptoms of asthma when I was a child.": Childhood asthma is not a significant concern in end-stage liver disease or transplant eligibility. It does not have a direct impact on the client’s current health status or the potential success of the liver transplant.

B. "My parent has type 2 diabetes mellitus.": While family medical history is relevant, having a parent with type 2 diabetes mellitus is not a contraindication for liver transplantation. The client’s own health status and adherence to medical care are more important.

C. "I am not very good about taking prescribed medication.": Post-transplant care requires strict adherence to medications, especially immunosuppressive drugs, to prevent organ rejection. If the client has a history of nonadherence, this can jeopardize the success of the transplant.

D. "I wish my family was more supportive of my decision.": This statement pertains to psychosocial concerns and can be addressed with counseling or support services. It does not pose an immediate medical concern for the transplant process.

A. Hgb 11.5 g/dL (12 to 16 g/dL) B. Creatinine 3.2 mg/dL (0.5 to 1.1 mg/dL) C. Sodium 146 mEq/L (136 to 145 mEq/L) D. WBC count 12,000/mm3 (5,000 to 10,000/mm3)

Correct Answer is B

Explanation

A. Hgb 11.5 g/dL (12 to 16 g/dL): While this hemoglobin level is slightly below normal, it is not an immediate priority compared to other more concerning values. Anemia could be addressed later with appropriate interventions but is not life-threatening in this case.

B. Creatinine 3.2 mg/dL (0.5 to 1.1 mg/dL): A creatinine level of 3.2 mg/dL is significantly elevated and indicates possible kidney dysfunction or acute kidney injury. Gentamicin is known to be nephrotoxic, and this level requires prompt attention to prevent further renal damage.

C. Sodium 146 mEq/L (136 to 145 mEq/L): Sodium levels are only slightly elevated and do not represent an immediate concern unless the client has symptoms of hypernatremia (e.g., confusion, seizures). While monitoring is required, it is not as urgent as the creatinine.

D. WBC count 12,000/mm3 (5,000 to 10,000/mm3): A WBC count of 12,000/mm3 is mildly elevated, which could suggest an infection or inflammation. However, this is not the priority compared to the kidney function, which could be compromised by gentamicin therapy.

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A nurse is changing the dressing for a client who is receiving peritoneal dialysis. Which of the following actions should the nurse take?

Nursing Test Bank

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