Your patient receives peritoneal dialysis (PD) at home. You know that which of the following occurs during the inflow or fill phase?
A prescribed volume of dialysate solution is infused through a catheter into the peritoneal space and inflow clamp is closed
Waste products and fluids are drained from the peritoneal space into the drainage bag
Diffusion and osmosis are occurring between patient's blood and peritoneal cavity
Access to AV graft is obtained with 2 large bore needles
The Correct Answer is A
A. A prescribed volume of dialysate solution is infused through a catheter into the peritoneal space and inflow clamp is closed is correct because the inflow (fill) phase of PD involves introducing a prescribed amount of dialysis solution into the peritoneal cavity through a tenckhoff catheter. Once the solution has entered, the inflow clamp is closed, allowing the patient to proceed to the dwell phase.
B. Waste products and fluids are drained from the peritoneal space into the drainage bag is incorrect because this describes the drain phase, which occurs after the dwell phase. During drainage, toxins, excess electrolytes, and fluid move from the blood into the dialysate and are removed from the peritoneal cavity.
C. Diffusion and osmosis are occurring between patient's blood and peritoneal cavity is incorrect because this process occurs primarily during the dwell (equilibration) phase, not the inflow phase. During dwell, waste products and excess fluid move from the bloodstream into the dialysate via osmosis and diffusion.
D. Access to AV graft is obtained with 2 large bore needles is incorrect because this describes hemodialysis, not peritoneal dialysis. PD uses a catheter in the peritoneal cavity rather than vascular access.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Remove offending medication is incorrect because this approach applies to intrarenal causes of AKI, such as nephrotoxic medications like NSAIDs, aminoglycosides, or contrast dyes. While stopping these drugs can prevent further kidney damage, it does not address the actual cause of postrenal AKI, which is a mechanical blockage in the urinary tract.
B. Correct hypovolemia with IV fluids is incorrect because this intervention targets prerenal AKI, where reduced kidney perfusion due to dehydration, blood loss, or hypotension is the issue. In postrenal AKI, the problem is urine flow obstruction, not perfusion. Administering fluids alone will not restore kidney functionand may even worsen complications if hydronephrosis is present.
C. Remove obstruction is correct because postrenal AKI occurs when urine cannot exit the kidneys due to a blockage, leading to back pressure, hydronephrosis, and impaired filtration. In this case, kidney stones are the obstructing factor. Effective management requires rapid relief of the obstructionthrough interventions such as stone removal, ureteral stenting, catheterization, or surgery, depending on the location and size of the obstruction. Relieving the obstruction restores urine flow, reduces pressure on the kidneys, prevents permanent damage, and decreases the risk of infection or electrolyte imbalances.
D. Ask about medication history is incorrect because although understanding a patient’s medication use is important for overall kidney health and identifying nephrotoxic drugs, it does not treat the obstruction causing postrenal AKI. This step is supportive rather than curative in this acute scenario.
Correct Answer is B
Explanation
A. Elevated body temp, systolic hypertension and irregular respirations is incorrect because while hyperthermia may accompany severe brain injury, it is not part of the classic signs indicating brainstem compression.
B. Systolic hypertension with widening pulse pressure, bradycardia with a full and bounding pulse, and irregular respirations is correct. This combination is known as Cushing’s triad, which is a hallmark of increased intracranial pressure causing brainstem compression. These findings indicate impending herniation and potential deathif not managed immediately. The triad occurs due to autonomic nervous system responses to rising ICP, with systolic hypertension attempting to maintain cerebral perfusion, bradycardia resulting from baroreceptor reflex, and irregular respirations caused by brainstem dysfunction.
C. Tachycardia and hypertension is incorrect because tachycardia is not typical in Cushing’s triad; bradycardia is the key cardiac sign associated with rising ICP and impending brainstem herniation.
D. Dizziness, fever and headache is incorrect because these are nonspecific symptomsand do not reliably indicate brainstem compression or imminent death. They may be seen in early or mild ICP elevation but are not diagnostic of severe brain injury.
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