A nurse is caring for a client who is undergoing initial peritoneal dialysis. Which of the following should the nurse
report immediately to the provider?

Choice A reason: Warming the dialysate in a microwave oven is not recommended because uneven heating could occur, leading to hot spots that can burn the peritoneal cavity. The dialysate should be warmed to body temperature using a warming device designed for this purpose.

Choice B reason: While some discomfort may be experienced during the first few exchanges, significant pain is not expected. If pain occurs, it should be reported to a healthcare provider, as it may indicate an underlying problem.

Choice C reason: Redness at the catheter exit site is not a normal expectation and could indicate an infection. The site should be kept clean and dry, and any signs of redness, swelling, or discharge should be reported to a healthcare provider immediately.

Choice D reason: There is no need to avoid foods high in fiber unless otherwise advised by a healthcare provider. In fact, a diet high in fiber can be beneficial for bowel regularity, which is important for patients on peritoneal dialysis.

Choice A reason: Epoetin alfa is used to treat anemia associated with chronic kidney disease, and iron supplementation is often required to support red blood cell production.

Choice B reason: Sodium intake does not need to be increased with epoetin alfa therapy and should be monitored carefully in clients with chronic kidney disease.

Choice C reason: Potassium levels should be monitored in chronic kidney disease and not necessarily increased, as hyperkalemia can be a concern.

Choice D reason: Protein intake should be managed carefully in chronic kidney disease to avoid excess nitrogen waste, which can be difficult for damaged kidneys to filter.