The healthcare provider has determined that a client has contracted hepatitis A based on flu-like symptoms and jaundice. Which statement made by the client supports this medical diagnosis?

Choice A reason: A client who works in a child care center is not typically at risk for hepatitis C unless they are exposed to blood or bodily fluids from an infected individual. Hepatitis C is primarily spread through blood-to-blood contact. While working in a child care center may increase the risk of exposure to various infections due to close contact with children, it is not a common route of transmission for hepatitis C.

Choice B reason: Eating raw shellfish is more commonly associated with hepatitis A and E, which are transmitted through the fecal-oral route, often due to contaminated food or water. Hepatitis C, however, is not typically transmitted through food or water. It is a bloodborne virus, and thus, eating raw shellfish would not be considered a high-risk activity for contracting hepatitis C.

Choice C reason: A client who has multiple tattoos is at risk for developing hepatitis C, particularly if the tattoos were done using non-sterile equipment or in an unregulated setting. The hepatitis C virus can be transmitted through the use of contaminated needles, which can occur in tattoo parlors that do not adhere to strict hygiene and sterilization practices. This is why choice C is the correct answer. While all the options presented could potentially involve some risk of infection, it is the client with multiple tattoos who is most at risk for hepatitis C, assuming the tattoos were obtained in a setting where infection control practices were not followed. It’s important for healthcare providers to assess each client’s individual risk factors and educate them on the ways to prevent hepatitis C, such as ensuring the use of sterile needles for tattoos and piercings.

Choice D reason: Traveling to an underdeveloped country may increase the risk of various infectious diseases, but hepatitis C is not commonly spread through casual contact or environmental factors. It requires blood-to-blood contact for transmission. Therefore, unless the client engaged in activities that involved such exposure, like receiving medical or dental procedures with non-sterile equipment, simply traveling to an underdeveloped country does not significantly increase the risk of contracting hepatitis C.

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.