Question

Joni Winters, a 64-year-old female client, is admitted with a fractured hip. She has chronic renal failure and has continuous peritoneal dialysis (CAPD) exchanges every 6 hours. The Tenckhoft peritoneal catheter site has redness, which goes across the abdomen. The client states that her abdomen is tender to touch all over, and the nurse notes the abdomen is rigid. The bowel sounds are decreased, and the peritoneal dialysate is in the dwelling phase of the cycle. The vital signs are T, 101°F; BP, 140/90 mm Hg; HR, 110 beats/minute; RR, 28 breaths/minute. The client asks the LPN/LVN to provide the peritoneal dialysis because she has a broken hip and cannot manage it.

a. What additional nursing assessment is needed before reporting the findings to the RN and the physician?

b. Explain the process of providing a single peritoneal dialysis exchange and the assessment needed during the exchange.

what am i missing this is the excact question that was given to me

Answer 1

A.

Answer: There is no need to do more assessment because already the patient is having signs of peritonitis. There is having fever, tenderness, redness in the catheter site is the common sign of infection. The PPN/LVN should be informed to the registered nurse or doctor immediately. Because the infection may spread very fast to other organs.

B.

Answer: First a peritoneal tube is placed in the peritoneal cavity through surgery. After that dialysate should connect to the tube to one port and another port with the drain line. The bag containing dialysate should keep above the heart level and drain line below the body. Then start the flow of dialysate into the peritoneal cavity through the tube and allow the fluid to stay inside for 4- 6 hours. During this time the fluid will absorb all the waste products and release the fluid along with the product through the drain line. The assessment needed to check for any development of chill, fever, distension of the abdomen. There should be check for any leakage and time should be maintain properly to help proper absorption of the waste product.