The nurse is administering peritoneal dialysis to a client with ...

[bobypop]

The nurse is administering peritoneal dialysis to a client with acute renal failure. The nurse notes the presence of a cloudy dialysate return.
 
  After notifying the health care provider, which action by the nurse is the most appropriate?
  A) Measure abdominal girth.
  B) Document the cloudy dialysate.
  C) Culture the dialysate return.
  D) Increase dialysate instillation.

Question 2

A young school-age client is in the hospital with acute renal failure following a streptococcus infection. The parents are Spanish-speaking and speak little English.
 
  The parents, through an interpreter, ask the nurse what mistake they made that caused the child to be so sick. Which response by the nurse is the most appropriate?
  A) Your child does not have enough dietary protein.
  B) Your child has a congenital defect that led to renal failure.
  C) Your child's renal failure has been caused by a low calcium level.
  D) Your child's recent infection may have caused the renal failure.

[atrochim]

Answer to Question 1

Answer: C

The return should be clear. The presence of cloudy drainage might indicate peritonitis, and the nurse should culture the return in order to help identify the presence and type of organism that could be causing the infection. Documenting the cloudy dialysate and nursing actions taken would be necessary, but is not the next-priority action. Measurement of abdominal girth is performed prior to the dialysis procedure, and although increased girth could indicate peritonitis, culturing the return is more important. The instillation part of the procedure is completed prior to the collection of the dialysate return, and the rate of the instillation has no relationship to the development of an infection.

Answer to Question 2

Answer: D

Clients with streptococcus are at risk for kidney and cardiac sequelae. In this case, the child has no evidence of a congenital defect leading to acute renal failure (ARF). A low-protein or low-calcium diet will not lead to ARF.

[bobypop]

Thank you

[atrochim]

No problemo