Urinary Disorders Q 95 - Gyan Darpan : Learning Portal
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Tuesday, 5 April 2022

Urinary Disorders Q 95

The nurse is monitoring a client receiving peritoneal dialysis and the nurse notes that a client’s outflow is less than the inflow. Which of the following actions will the nurse take. Select all that apply.
    A. Place the client in good body alignment.
    B. Check the level of the drainage bag.
    C. Contact the physician.
    D. Check the peritoneal dialysis system for kinks.
    E. Reposition the client to his or her side.

Correct Answers: A, B, D, & E.

Maintain a record of inflow and outflow volumes and cumulative fluid balance. In most cases, the amount drained should equal or exceed the amount instilled. A positive balance indicates a need of further evaluation.

Option A: If outflow drainage is inadequate, the nurse attempts to stimulate outflow by changing the client’s position. Assess the patency of catheter, noting difficulty in draining. Note the presence of fibrin strings and plugs. Slowing of flow rate and presence of fibrin suggests partial catheter occlusion requiring further evaluation and intervention.
Option B: The drainage bag needs to be lower than the client’s abdomen to enhance gravity drainage. Improper functioning of equipment may result in retained fluid in the abdomen and insufficient clearance of toxins.
Option C: There is no reason to contact the physician. Evaluate development of tachypnea, dyspnea, increased respiratory effort. Drain dialysate, and notify the physician. Abdominal distension and diaphragmatic compression may cause respiratory distress.
Option D: The connecting tubing and the peritoneal dialysis system is also checked for kinks or twisting and the clamps on the system are checked to ensure that they are open. Check tubing for kinks; note placement of bottles and bags. Anchor catheter so that adequate inflow/outflow is achieved.
Option E: Turning the client to the other side or making sure that the client is in good body alignment may assist with outflow drainage. Turn from side to side, elevate the head of the bed, apply gentle pressure to the abdomen. May enhance outflow of fluid when the catheter is malpositioned and obstructed by the omentum.

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