A patient is unsure of the decision to undergo peritoneal dialysis (PD) and wishes to discuss the advantages of this treatment with the nurse. Which statements by the nurse are accurate regarding PD? Select all that apply.

You will not need vascular access to perform PD.

This can be done in the comfort of your home.

You will have no risk for infection with PD.

You have some flexibility in when you do the exchanges.

It takes less time than hemodialysis treatments.

Answer and Explanation

Correct Answer : A,B,D,E

Choice A reason: Not needing vascular access to perform PD is a significant advantage for patients. Peritoneal dialysis uses the peritoneal membrane in the abdomen as a filter to clean the blood, which eliminates the need for vascular access, such as fistulas or catheters required in hemodialysis. This can reduce the risks associated with vascular access, such as infections and complications related to surgical procedures.

Choice B reason: Being able to perform PD in the comfort of one's home is a major benefit. Patients can manage their dialysis treatments at home, which offers more convenience and flexibility compared to traveling to a dialysis center for hemodialysis sessions. This can greatly improve the quality of life and reduce the burden of frequent trips to healthcare facilities.

Choice C reason: Stating that there is no risk for infection with PD is inaccurate. While PD offers many benefits, it does carry a risk of peritonitis, an infection of the peritoneal cavity. Patients must be educated on proper technique and hygiene to minimize this risk. Hence, this statement is not accurate and should not be included as an advantage.

Choice D reason: Having flexibility in when to do the exchanges is another benefit of PD. Patients can schedule their dialysis exchanges at times that best fit their lifestyle and daily routines. This flexibility allows for greater independence and freedom compared to the fixed schedules required for in-center hemodialysis.

Choice E reason: PD can take less time than hemodialysis treatments, especially when considering travel and waiting times associated with in-center hemodialysis. Although the actual dialysis process for PD requires regular exchanges throughout the day or night, it integrates more seamlessly into daily life, making it a time-efficient option for many patients.

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Correct Answer is D

Explanation

Choice A reason: The client with mitral valve stenosis experiencing heart palpitations is at risk of complications such as atrial fibrillation, which can lead to embolic events. While this is a serious condition that needs attention, it is not as immediately life-threatening as the presence of pink frothy sputum in a heart failure patient.

Choice B reason: The client with arterial occlusive disease and intermittent claudication is experiencing pain due to reduced blood flow to the extremities during activity. Although this condition requires management to prevent worsening ischemia, it is not as critical as the presentation of pink frothy sputum in a heart failure patient.

Choice C reason: The client with deep vein thrombosis (DVT) and an edematous right calf is at risk of developing a pulmonary embolism, which is a serious condition. However, the immediate symptoms do not suggest a current life-threatening emergency compared to the client with heart failure and pink frothy sputum.

Choice D reason: The client with heart failure who has pink frothy sputum must be assessed first. Pink frothy sputum is a sign of pulmonary edema, indicating severe left-sided heart failure. This condition is a medical emergency as it impairs gas exchange and can lead to respiratory failure if not promptly treated. Immediate intervention is necessary to stabilize the client's respiratory and cardiac status.

A. Respirations are labored and shallow. B. PaO2 50 mmHg. C. PaCO2 32 mmHg. D. Respiratory rate 32 breaths/min.

Correct Answer is A

Explanation

Choice A reason: Labored and shallow respirations indicate that the patient is struggling to breathe and may not be ventilating effectively. This can quickly lead to respiratory fatigue and failure, and it requires immediate intervention to support the patient's airway and breathing.

Choice B reason: A PaO2 level of 50 mmHg is significantly low, indicating hypoxemia. This is concerning and requires attention, but the immediate visual and tactile signs of labored and shallow breathing take precedence as they are indicative of the patient's overall respiratory effort and ability to maintain adequate ventilation.

Choice C reason: A PaCO2 level of 32 mmHg is low and suggests hyperventilation. While this finding is important, it is not as immediately critical as labored and shallow respirations, which can quickly deteriorate into complete respiratory failure.

Choice D reason: A respiratory rate of 32 breaths/min indicates tachypnea, which is a sign of respiratory distress. However, the quality of respirations (labored and shallow) is a more immediate concern as it directly affects the patient's ability to ventilate and oxygenate effectively.

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