Which of the following is a potential side effect of peritoneal dialysis?

Choice a reason: Laboratory results indicating a high level of an aminoglycoside can point to nephrotoxicity, which is a type of intrinsic renal injury. Aminoglycosides are antibiotics that can be toxic to the kidneys, causing damage to renal tissues. This condition is different from prerenal injury, which is related to reduced blood flow to the kidneys, not direct damage from toxins.
Choice b reason: A tumor obstruction in the right ureter is indicative of postrenal injury, which occurs due to obstruction of urine flow anywhere along the urinary tract. This kind of injury does not fall under the category of prerenal injury, which is due to factors causing reduced perfusion to the kidneys.
Choice c reason: A family history of polycystic kidney disease (PKD) suggests a genetic predisposition to intrinsic renal disease. PKD is a hereditary condition that leads to the formation of cysts in the kidneys, eventually impairing their function. This type of injury is not prerenal, as it results from structural abnormalities within the kidney itself.
Choice d reason: Impaired blood flow to the kidneys is the hallmark of prerenal injury. Prerenal injuries are caused by conditions that reduce renal perfusion, such as dehydration, heart failure, or shock. When the kidneys receive insufficient blood flow, they cannot function properly, leading to symptoms of renal insufficiency. Addressing the underlying cause to restore adequate blood flow is crucial in managing prerenal injury.

Choice a reason: Cleansing the area with hot water and soap is not recommended for managing skin irritation around the stoma. Hot water can further irritate the skin and soap may strip away natural oils, exacerbating the irritation. The skin around the stoma is sensitive and requires gentle care with mild cleansers and lukewarm water to prevent further irritation and damage.
Choice b reason: Avoiding the use of any type of moisturizer or lotion on the skin is not appropriate for managing skin irritation around the stoma. While certain products might not be suitable, using a proper moisturizer can help to soothe and protect the irritated skin. It's essential to choose a skin-compatible product designed for use around stomas to maintain skin health and prevent further irritation.
Choice c reason: Applying a protective barrier cream or paste around the stoma is the most appropriate intervention for managing skin irritation. These products create a protective layer between the skin and the ostomy appliance, reducing friction and irritation. They help to maintain the integrity of the skin, promote healing, and prevent further complications. Barrier creams and pastes are specifically formulated for use around stomas and are effective in protecting sensitive skin.
Choice d reason: Using adhesive tape to tightly secure the ostomy bag is not recommended for managing skin irritation around the stoma. Tightly applied adhesive tape can cause additional pressure and irritation to the already sensitive skin. Instead, it is better to use an ostomy appliance that fits well and is designed to adhere gently to the skin without causing irritation or damage. Proper fitting and gentle adhesion are key to preventing skin issues around the stoma.