What observation should you report to the nurse when caring for a patient with a peritoneal dialysis catheter?

A nurse assesses a client who has diabetes mellitus. Which arterial blood gas values should the nurse identify as potential ketoacidosis in this client?
a. pH 7.38, HCO3- 22 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg
b. pH 7.28, HCO3- 18 mEq/L, PCO2 28 mm Hg, PO2 98 mm Hg
c. pH 7.48, HCO3- 28 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg
d. pH 7.32, HCO3- 22 mEq/L, PCO2 58 mm Hg, PO2 88 mm Hg

A nurse prepares to administer insulin to a client at 1800. The client's medication administration record contains the following information:
• Insulin glargine: 12 units daily at 1800
• Regular insulin: 6 units QID at 0600, 1200, 1800, 2400
Based on the client's medication administration record, which action should the nurse take?
a. Draw up and inject the insulin glargine first, and then draw up and inject the regular insulin.
b. Draw up and inject the insulin glargine first, wait 20 minutes, and then draw up and inject the regular insulin.
c. First draw up the dose of regular insulin, then draw up the dose of insulin glargine in the same syringe, mix, and inject the two insulins together.
d. First draw up the dose of insulin glargine, then draw up the dose of regular insulin in the same syringe, mix, and inject the two insulins together.

A nurse prepares to administer prescribed regular and NPH insulin. Place the nurse's actions in the correct order to administer these medications.
1. Inspect bottles for expiration dates.
2. Gently roll the bottle of NPH between the hands.
3. Wash your hands.
4. Inject air into the regular insulin.
5. Withdraw the NPH insulin.
6. Withdraw the regular insulin.
7. Inject air into the NPH bottle.
8. Clean rubber stoppers with an alcohol swab.
a. 1, 3, 8, 2, 4, 6, 7, 5
b. 3, 1, 2, 8, 7, 4, 6, 5
c. 8, 1, 3, 2, 4, 6, 7, 5
d. 2, 3, 1, 8, 7, 5, 4, 6

Overview

Dialysis does the work of your kidneys when you have kidney failure. It filters wastes and removes extra fluid. It also keeps the right balance of chemicals in your blood. Peritoneal dialysis uses the lining of your belly to filter your blood.

Before you start dialysis, your doctor creates a dialysis access. This is the place where the dialysis solution can flow into and out of your body. To make the access, the doctor places a soft tube in your belly or chest. This tube is called a catheter. When you do dialysis, the solution flows into your belly and stays there for several hours. Then you remove it through the catheter.

It is important to take care of the catheter and the access area to prevent infection.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Care of the catheter and access

• After the doctor creates your access, keep the bandage dry and clean. Change a dirty or bloody bandage.
• Keep your access area clean and dry. Check it every day for signs of infection.
• Always clean and dry your catheter and access area right away after you get wet.
• Always wash your hands before you touch the catheter.
• Fasten or tape the catheter to your body to keep it from catching on your clothes.
• Never use scissors or other sharp objects around your catheter.
• Do not use unapproved clamps on your catheter.
• Store your dialysis supplies in a cool, dry place.

Activity when you have an access

• Do not lift heavy objects.
• Do not swim or take a bath unless your doctor tells you it is okay.

When should you call for help?

Call your doctor or nurse call line now or seek immediate medical care if:

• You have signs of infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the access area.
  • Pus draining from the access area.
  • A fever.
• You have belly pain.
• You have nausea or vomiting.
• The dialysis fluid looks cloudy or is a different colour.
• Fluid does not flow through the catheter.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter R310 in the search box to learn more about "Peritoneal Dialysis Catheter Care: Care Instructions".

What should you monitor during peritoneal dialysis?

Which action would the nurse take when caring for a patient with a peritoneal dialysis catheter?

What is the most common complication of peritoneal dialysis?

What are common complications and nursing issues with peritoneal dialysis?