A nurse is providing discharge teaching for a client who is to perform peritoneal dialysis at home. Which of the following information should the nurse include?
You should warm the dialysate in a microwave oven before instillation.
You should anticipate pain during the first week of the inflow of dialysate.
You should expect redness at the catheter exit site.
You should avoid foods high in fiber.
None of the above.
The Correct Answer is E
Choice A reason: Warming the dialysate in a microwave oven is not recommended because uneven heating could occur, leading to hot spots that can burn the peritoneal cavity. The dialysate should be warmed to body temperature using a warming device designed for this purpose.
Choice B reason: While some discomfort may be experienced during the first few exchanges, significant pain is not expected. If pain occurs, it should be reported to a healthcare provider, as it may indicate an underlying problem.
Choice C reason: Redness at the catheter exit site is not a normal expectation and could indicate an infection. The site should be kept clean and dry, and any signs of redness, swelling, or discharge should be reported to a healthcare provider immediately.
Choice D reason: There is no need to avoid foods high in fiber unless otherwise advised by a healthcare provider. In fact, a diet high in fiber can be beneficial for bowel regularity, which is important for patients on peritoneal dialysis.
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Correct Answer is D
Explanation
Choice A reason: Blood-tinged dialysate outflow can occur initially due to the surgical procedure and is not typically a cause for immediate concern unless it persists or is accompanied by other symptoms.
Choice B reason: Dialysate leakage during inflow might indicate a problem with the catheter placement or integrity but is not usually an emergency. It should be monitored and reported if it continues.
Choice C reason: Discomfort during dialysate inflow is common, especially in new patients, as they adjust to the sensation of fluid being infused. It should be reported if the discomfort is severe or persistent.
Choice D reason: Purulent dialysate outflow indicates an infection, such as peritonitis, which is a serious complication
of peritoneal dialysis. This requires immediate atention and intervention by the healthcare provider.
Correct Answer is B
Explanation
Choice A reason: This statement is incorrect because, during dehydration, water does not move towards areas of lower sodium concentration.
Choice B reason: This is correct because, during dehydration, the body retains sodium, and water follows by osmosis to areas where sodium concentration is higher, which can result in elevated sodium levels.
Choice C reason: Sodium does not typically move across membranes in response to solute concentration gradients; water does.
Choice D reason: Water moves independently of sodium particles, not necessarily together, and it moves towards areas of higher solute concentration.
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