Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a female client’s uremia. Which finding signals a significant problem during this procedure?
A. Potassium level of 3.5 mEq/L
B. Hematocrit (HCT) of 35%
C. Blood glucose level of 200 mg/dl
D. White blood cell (WBC) count of 20,000/mm3
Correct Answer: D. White blood cell (WBC) count of 20,000/mm3
An increased WBC count indicates infection, probably resulting from peritonitis, which may have been caused by insertion of the peritoneal catheter into the peritoneal cavity. Peritonitis can cause the peritoneal membrane to lose its ability to filter solutes; therefore, peritoneal dialysis would no longer be a treatment option for this client.
Option A: A potassium level of 3.5 mEq/L can be treated by adding potassium to the dialysate solution. People on peritoneal dialysis (PD) are usually encouraged to eat more potassium-rich foods than people dialyzing with traditional in-center hemodialysis. PD is performed daily and as a result, the body does not have as much potassium buildup.
Option B: An HCT of 35% is lower than normal. However, in this client, the value isn’t abnormally low because of the daily blood samplings. A lower HCT is common in clients with chronic renal failure because of the lack of erythropoietin.
Option D: Hyperglycemia occurs during peritoneal dialysis because of the high glucose content of the dialysate; it’s readily treatable with sliding-scale insulin. Since PD uses sugar-based solutions (glucose) to perform dialysis, people with diabetes starting PD often see a rise in their blood sugar levels. Very high sugar levels (greater than 300 mg/dl) can occur in PD patients, but it is uncommon for this to cause symptoms.
No comments:
Post a Comment