The client with chronic renal failure has an indwelling catheter for peritoneal dialysis in the abdomen. The client spills water on the catheter dressing while bathing. The nurse should immediately:
A. Reinforce the dressing.
B. Change the dressing.
C. Flush the peritoneal dialysis catheter.
D. Scrub the catheter with povidone-iodine.
Correct Answer: B. Change the dressing.
Clients with peritoneal dialysis catheters are at high risk for infection. A dressing that is wet is a conduit for bacteria to reach the catheter insertion site. The nurse assures that the dressing is kept dry at all times. A moist environment promotes bacterial growth. Purulent drainage at the insertion site suggests the presence of local infection.
Option A: Reinforcing the dressing is not a safe practice to prevent infection in this circumstance. Change dressings as indicated, being careful not to dislodge the catheter. Note character, color, odor, or drainage from around the insertion site.
Option C: Flushing the catheter is not indicated. Observe meticulous aseptic techniques and wear masks during catheter insertion, dressing changes, and whenever the system is opened. Change tubings per protocol.
Option D: Scrubbing the catheter with povidone-iodine is done at the time of connection or disconnecting of peritoneal dialysis. Apply povidone-iodine (Betadine) barrier in distal, clamped portion of catheter when intermittent dialysis therapy used. Reduces risk of bacterial entry through catheter between dialysis treatments when the catheter is disconnected from the closed system.
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