A nurse is teaching a client who has chronic kidney disease about the process of continuous ambulatory peritoneal dialysis (CAPD). Which of the following information should the nurse include in the teaching?
CAPD is the dialysis treatment of choice for clients who have a history of abdominal surgery.
CAPD requires a rigid schedule of exchange times.
CAPD requires the client to follow fewer dietary and fluid restrictions than hemodialysis requires.
CAPD filters the client's blood through an artificial device called a dialyzer.
The Correct Answer is C
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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Correct Answer is C
Explanation
Choice A reason: Maintaining the client in a left lateral position is not specifically required for peritoneal dialysis. Positioning may vary based on the individual's comfort and specific medical needs.
Choice B reason: While monitoring vital signs is important during any medical procedure, it is not an intervention that directly ensures proper dialysate exchange in peritoneal dialysis.
Choice C reason: Warming the dialysate solution prior to instillation is a standard practice in peritoneal dialysis. It helps to promote patient comfort and more efficient exchange of wastes and fluids.
Choice D reason: Placing the drainage bag above the level of the client's abdomen would impede gravity drainage, which is necessary for proper dialysate exchange. The drainage bag should be placed below the level of the client's abdomen.
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Correct Answer is D
Explanation
Choice A reason: A pH of 7.26 indicates acidosis, but an HCO3 of 24 and PaCO2 of 46 suggest a respiratory cause rather than metabolic, which is not typical for AKI.
Choice B reason: A pH of 7.49 indicates alkalosis, and with an HCO3 of 30 and PaCO2 of 40, this suggests metabolic alkalosis, which is not expected in AKI.
Choice C reason: A pH of 7.49 indicates alkalosis. An HCO3 of 24 is normal, and a PaCO2 of 30 would suggest respiratory alkalosis, not typically associated with AKI.
Choice D reason: A pH of 7.26 indicates acidosis, and with an HCO3 of 14, this suggests metabolic acidosis, which is consistent with AKI. The PaCO2 of 30 indicates a compensatory respiratory response to the metabolic acidosis. This ABG result aligns with the expected findings in a patient with AKI, where there is an accumulation of acids and a decrease in bicarbonate due to the kidneys' inability to filter and excrete hydrogen ions effectively.
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