A nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis due to the risk of which complication?

Hyperglycemia

Disequilibrium syndrome

Peritonitis

Hyperphosphatemia

The client experiences pain upon palpation of the epigastric region.

Answer and Explanation

The Correct Answer is A

Choice A: Hyperglycemia The reason hyperglycemia is a risk when the prescribed dwell time is not maintained is due to the glucose present in the dialysate. The dialysate used in PD often contains glucose, which acts as an osmotic agent to facilitate fluid removal from the blood. If the dwell time is too short, there may not be enough time for the glucose to be absorbed, leading to higher levels of glucose in the blood. Conversely, if the dwell time is too long, excessive glucose absorption can occur, also leading to hyperglycemia. For patients with diabetes mellitus, maintaining the prescribed dwell time is essential to manage their blood glucose levels effectively. The normal range for fasting blood glucose is typically between 70 to 99 mg/dL, and for diabetes patients, maintaining blood glucose levels as close to the normal range as possible is crucial to prevent complications.

Choice B: Disequilibrium Syndrome Disequilibrium syndrome is characterized by neurological symptoms resulting from rapid changes in the composition of extracellular fluids during dialysis. This condition is more commonly associated with hemodialysis due to the rapid shifts that can occur with this modality. In PD, the risk of disequilibrium syndrome is significantly lower because the exchange of solutes and fluids is more gradual. Therefore, while important to consider, it is not the primary complication associated with the maintenance of dwell time in PD.

Choice C: Peritonitis Peritonitis, an infection of the peritoneal cavity, is a serious complication of PD but is not directly related to the duration of dwell time. It is typically caused by contamination during the exchange process or catheter-related infections. While proper technique and hygiene are critical in preventing peritonitis, the dwell time itself does not influence the risk of developing this infection.

Choice D: Hyperphosphatemia Hyperphosphatemia refers to elevated levels of phosphate in the blood and is a concern in patients with renal failure due to the kidneys’ inability to excrete phosphate effectively. The dwell time in PD may affect the removal of phosphate to some extent; however, it is not the primary concern related to the maintenance of dwell time. Phosphate binders and dietary restrictions are commonly used to manage phosphate levels in PD patients.

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Correct Answer is B

Explanation

Choice A reason: The GFR does not recover during the oliguric phase; instead, it is typically reduced, reflecting impaired kidney function.

Choice B reason: Urine output of less than 400 mL per 24 hours is characteristic of the oliguric phase of AKI. This phase can last from 1 to 7 days after kidney injury and is a crucial time for monitoring and managing the patient's fluid and electrolyte balance.

Choice C reason: BUN and creatinine levels do not decrease during the oliguric phase. They usually increase due to reduced kidney function and the inability to excrete these waste products.

Choice D reason: Renal function is not reestablished during the oliguric phase. This phase is part of the course of AKI where renal function is at its lowest, and recovery has not yet begun.

A. Disequilibrium syndrome B. Septicemia C. Air embolism D. Peritonitis

Correct Answer is A

Explanation

Choice A reason: Disequilibrium syndrome is characterized by headache, nausea, and agitation, which can occur during or after hemodialysis, especially in the first few sessions as the body adjusts to the treatment².

Choice B reason: Septicemia would typically present with fever, chills, and hypotension, not specifically headache and agitation².

Choice C reason: Air embolism is a rare complication that would present with sudden respiratory distress, chest pain, and possibly hypotension, not just headache and agitation².

Choice D reason: Peritonitis is associated with abdominal pain and tenderness, fever, and possibly altered bowel movements, not the symptoms described².

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A nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis due to the risk of which complication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has acute kidney injury (AKI) about the oliguric phase. Which of the following information should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is caring for a client during his first hemodialysis treatment. The client reports a headache, nausea, and is agitated. Which of the following complications should the nurse identify these findings as manifestations of?

Correct Answer is A

Explanation

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