A nurse is providing discharge teaching to a client who will be performing continuous ambulatory peritoneal dialysis (CAPD) at home. Which of the following statements from the client indicates an understanding of this type of dialysis management? (Select all that apply)
"I must wash my hands every time before I connect the tubing to the catheter in my stomach."
"I will lay down for 4 to 6 hours every time the new solution is dwelling in my peritoneal cavity."
"I will weigh myself daily and keep track of my weight in my dialysis record."
"I will complete the instillation of fluid once a day at bedtime."
"I will check my blood pressure and follow the instructions related to changes I might need to do based on the results."
Correct Answer : A,C,E
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.
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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 D
Explanation
Choice A reason: An elevated creatinine level indicates reduced kidney function, which is often the reason a kidney biopsy is being performed in the first place. It is not a contraindication for the procedure.
Choice B reason: Urinary retention does not directly impact the ability to perform a kidney biopsy, as the procedure involves the kidneys and not the lower urinary tract where urine is stored.
Choice C reason: Flank pain is a common symptom in patients with kidney issues and is not a contraindication for a kidney biopsy. The procedure may help diagnose the cause of the ?ank pain.
Choice D reason: Bleeding tendencies are a significant contraindication for a kidney biopsy. Patients with a history of bleeding disorders or those on anticoagulant therapy are at increased risk of bleeding complications from the procedure.
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