A client newly diagnosed with renal failure is receiving peritoneal dialysis. During the infusion of the dialysate the client complains of abdominal pain. Which action by the nurse is most appropriate?
A. Slow the infusion.
B. Decrease the amount to be infused.
C. Explain that the pain will subside after the first few exchanges.
D. Stop the dialysis.
Correct Answer: C. Explain that the pain will subside after the first few exchanges.
Pain during the inflow of dialysate is common during the first few exchanges because of peritoneal irritation; however, the pain usually disappears after 1 to 2 weeks of treatment. The infusion amount should not be decreased, and the infusion should not be slowed or stopped.
Option A: Explain that initial discomfort usually subsides after the first few exchanges. Monitor for pain that begins during inflow and continues during the equilibration phase. Slow infusion rate as indicated. Pain occurs at these times if acidic dialysate causes a chemical irritation of the peritoneal membrane.
Option B: Do not decrease the infusion amount. Note reports of discomfort that is most pronounced near the end of inflow and instill no more than 2000 mL of solution at a single time. Likely the result of abdominal distension from dialysate. The amount of infusion may have to be decreased initially.
Option D: Stopping the dialysis is unnecessary. Elevate the head of bed at intervals. Turn the patient from side to side. Provide back care and tissue massage. Position changes and gentle massage may relieve abdominal and general muscle discomfort.
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