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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Weight gain is not typically a direct cause of chronic pancreatitis. While obesity can be a risk factor for developing pancreatitis, it is not considered a primary cause.
Choice B reason: The use of alcohol is the most common cause of chronic pancreatitis. Long-term alcohol misuse can lead to the development of chronic pancreatitis, accounting for about 70% of cases³.
Choice C reason: Abdominal pain that is relieved with food or antacids is more indicative of conditions like peptic ulcers rather than chronic pancreatitis.
Choice D reason:Exposure to occupational chemicals has not been established as a primary cause of chronic pancreatitis. While certain toxins can affect the pancreas, they are not a common cause of chronic pancreatitis.
Correct Answer is ["0.2"]
Explanation
- Step 1: Identify the required dose in milligrams (mg). The nurse is scheduled to administer 2 mg of morphine sulfate.
- Step 2: Identify the concentration of the available solution. The available solution contains 10 mg of morphine sulfate per 1 mL.
- Step 3: Calculate the volume of solution needed to deliver the required dose. We can set up a proportion to solve for this:
- 10 mg is to 1 mL as 2 mg is to X mL.
- In other words, 10 mg : 1 mL = 2 mg : X mL.
- Step 4: Solve for X using cross-multiplication and division:
- Cross-multiplication gives us: 10 mg × X mL = 2 mg × 1 mL.
- Simplifying this gives us: 10X = 2.
- Dividing both sides by 10 gives us: X = 2 ÷ 10.
- Calculating the division gives us: X = 0.2.
So, the nurse should administer 0.2 mL of the morphine sulfate solution per dose.
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