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 ["A","B","D"]

No explanation

A. Tape the connections on the client's chest tube. B. Position the client in a supine position. C. Strip the client's chest tube every 2 hours. D. Place the chest tube drainage system above the level of the client's heart.

Correct Answer is A

Explanation

Choice A reason:Taping the connections on the client's chest tube is essential to maintain a closed system and prevent air leaks, which could lead to a pneumothorax.

Choice B reason:Positioning the client in a supine position is not recommended as it may not facilitate optimal drainage from the pleural space.

Choice C reason:Stripping the chest tube, which involves applying pressure and sliding the fingers down the tube to remove clots, is not routinely recommended as it can generate high negative pressures and damage lung tissue.

Choice D reason: The chest tube drainage system should be placed below the level of the client's heart to allow for gravity drainage of pleural fluid and air.

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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

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Correct Answer is ["A","B","D"]

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Correct Answer is A

Explanation

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