The nurse is visiting a patient who performs peritoneal dialysis at home. The nurse is evaluating the patient's technique. Which finding requires additional teaching?

Choice a reason: The patient uses clean technique when instilling the dialysate is incorrect and requires additional teaching. Peritoneal dialysis requires sterile technique to prevent infection. Using a clean technique, which is less rigorous than sterile technique, increases the risk of introducing pathogens into the peritoneal cavity. Proper sterile technique involves meticulous hand hygiene, using sterile gloves, and ensuring all equipment and supplies are sterile.
Choice b reason: The patient performs exchanges on a table with a sterile drape is appropriate. Using a sterile drape helps maintain a sterile field and reduces the risk of contamination during the dialysis procedure. This practice is an important part of sterile technique and helps ensure the patient's safety.
Choice c reason: The patient verbally expresses symptoms to report to the HCP is a positive behavior. Being aware of and communicating symptoms that may indicate complications, such as signs of infection or peritonitis, is crucial for timely intervention and management. This practice shows the patient is knowledgeable about monitoring their health and knowing when to seek professional help.
Choice d reason: The patient washes their hands before beginning is an essential step in both clean and sterile techniques. Proper hand hygiene is critical in preventing the spread of infection and is a fundamental practice in peritoneal dialysis. Washing hands thoroughly before starting the procedure helps minimize the risk of contamination.

Choice a reason: Weak pelvic floor muscles are a common cause of urinary incontinence. These muscles support the bladder and urethra, and when they are weakened, it can lead to involuntary leakage of urine, especially during activities that increase abdominal pressure, such as coughing, sneezing, or lifting. Strengthening these muscles through exercises like Kegels can help improve urinary control.
Choice b reason: Excessive fluid intake can lead to increased urine production and a higher frequency of urination, but it is not a direct cause of urinary incontinence. Proper hydration is important for overall health, and excessive fluid intake alone does not weaken the mechanisms that control urine flow.
Choice c reason: Poor perineal care after stool incontinence can lead to infections and skin irritation but is not a direct cause of urinary incontinence. Maintaining good hygiene is crucial for preventing complications and infections, but it does not impact the muscular control of the bladder and urethra.
Choice d reason: High levels of bladder pressure can contribute to urgency and frequency but are not typically classified as a common cause of urinary incontinence. Conditions that lead to increased bladder pressure, such as bladder obstruction or overactive bladder, may result in symptoms that overlap with incontinence, but they are distinct in their causes and management.