A client is unsure of the decision to undergo peritoneal dialysis ...

[theo]

A client 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.)
 
  a. You will not need vascular access to perform PD.
  b. There is less restriction of protein and fluids.
  c. You will have no risk for infection with PD.
  d. You have flexible scheduling for the exchanges.
  e. It takes less time than hemodialysis treatments.

Question 2

A client is undergoing hemodialysis. The client's blood pressure at the beginning of the procedure was 136/88 mm Hg, and now it is 110/54 mm Hg. What actions should the nurse perform to maintain blood pressure? (Select all that apply.)
 
  a. Adjust the rate of extracorporeal blood flow.
  b. Place the client in the Trendelenburg position.
  c. Stop the hemodialysis treatment.
  d. Administer a 250-mL bolus of normal saline.
  e. Contact the health care provider for orders.

[IAPPLET]

Answer to Question 1

ANS: A, B, D
PD is based on exchanges of waste, fluid, and electrolytes in the peritoneal cavity. There is no need for vascular access. Protein is lost in the exchange, which allows for more protein and fluid in the diet. There is flexibility in the time for exchanges, but the treatment takes a longer period of time compared to hemodialysis. There still is risk for infection with PD, especially peritonitis.

Answer to Question 2

ANS: A, B, D
Hypotension occurs often during hemodialysis treatments as a result of vasodilation from the warmed dialysate. Modest decreases in blood pressure, as is the case with this client, can be maintained with rate adjustment, Trendelenburg positioning, and a fluid bolus. If the blood pressure drops considerably after two boluses and cooling dialysate, the hemodialysis can be stopped and the health care provider contacted.

[theo]

Excellent

[samiel-sayed]

TYSM