A nurse is caring for a client who has polycystic kidney disease (PKD). The client is admited to the hospital for renal calculi and reports that their abdomen has been getting bigger. Which of the following statements by the nurse is the best explanation for the increase in abdominal girth?
"The kidney infection has caused narrowing of the ureters, and your abdomen has filled with fluid."
"The kidneys continue to enlarge due to the cysts growing, which increases the girth of your abdomen."
"The stones might descend into the ureters, blocking the flow of urine and causing an increase in the girth of your abdomen."
"The in?ammation in your kidneys damages the filtration system, which causes fluid retention in your abdomen."
The Correct Answer is B
Choice A reason: While kidney infections can cause swelling, they typically do not lead to a significant increase in abdominal girth unless associated with severe obstruction or advanced kidney disease.
Choice B reason: In PKD, the kidneys can become significantly enlarged due to the growth of numerous cysts, which
can indeed lead to an increase in abdominal girth.
Choice C reason: While stones can cause blockage and swelling, they would not typically result in a generalized increase in abdominal girth unless there is an associated infection or severe obstruction.
Choice D reason: Inflammation can lead to fluid retention, but in the context of PKD, it is the cysts' growth that primarily contributes to increased kidney size and abdominal girth.
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Correct Answer is D
Explanation
Choice A reason: Blood-tinged dialysate outflow can occur initially due to the surgical procedure and is not typically a cause for immediate concern unless it persists or is accompanied by other symptoms.
Choice B reason: Dialysate leakage during inflow might indicate a problem with the catheter placement or integrity but is not usually an emergency. It should be monitored and reported if it continues.
Choice C reason: Discomfort during dialysate inflow is common, especially in new patients, as they adjust to the sensation of fluid being infused. It should be reported if the discomfort is severe or persistent.
Choice D reason: Purulent dialysate outflow indicates an infection, such as peritonitis, which is a serious complication
of peritoneal dialysis. This requires immediate atention and intervention by the healthcare provider.
Correct Answer is C
Explanation
Choice A reason: CAPD can be suitable for clients with a history of abdominal surgery, but it is not specifically the
treatment of choice due to this reason alone.
Choice B reason: CAPD does not require a rigid schedule of exchange times. It is ?exible and can be adjusted to fit the client's lifestyle.
Choice C reason: CAPD allows for more dietary and fluid freedom compared to hemodialysis because it is a continuous process that removes waste products and excess fluid more gradually.
Choice D reason: CAPD does not filter the client's blood through an artificial device called a dialyzer; that is a description of hemodialysis. CAPD uses the client's peritoneum as the filter to remove waste products and excess fluid.
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