Which of the following are *goals* of dialysis? Select all that apply.
A. remove creatinine and urea
B. maintain a safe concentration of electrolytes, especially potassium
C. correct alkalosis and replenish the blood bicarbonate buffer system
D. increase fluid in the blood - Answers A and B
dialysis corrects *acidosis* and removes *excess* fluid from the blood (kidneys are not able to
excrete optimal amounts of urine, so patients on dialysis will likely have very little/no urine
output)
Which of the following is *not true* about dialysis?
A. without dialysis, patients require an in and out catheter every 24 hours
B. hemodialysis cannot be done at home; peritoneal dialysis can
C. if a patient is receiving dialysis 3 times a week, they likely only need an in and out catheter
every few days
D. may be used to treat drug overdoses - Answers A
without dialysis, patients require an in and out catheter every ~8 hours
You are a community nurse working with a patient who does peritoneal dialysis at home. Today,
you have a student shadowing you. Which of the following statements by the student requires
further teaching?
A. "glucose is added to the dialysate to create an osmotic gradient so excess fluid is pulled from
the blood"
B. "sterile dialysate is instilled into the peritoneal cavity to allow for substance exchange"
C. "dwell time for substance exchange is 4 hours"
,D. "the three processes that occur during dwell time are diffusion, osmosis, and ultrafiltration" -
Answers C
dwell time is prescribed based on the patients goals
You are working in the community with a student. Which of the following statements by the
student about peritoneal dialysis requires further teaching?
A. "the catheter won't be sealed for one to two weeks after insertion"
B. "exit site care should be done using antibacterial soap, or mild disinfectant, and patients
should always assess for signs of infection"
C. "two to four weeks after the catheter is implanted, the exit site should be clean, dry and have
no redness or tenderness"
D. "patients should perform exit site care once a week" - Answers D
exit site care should be done daily or every second day
Which of the following is *false* about dialysis solutions and cycles?
A. ultrafiltration often involves dextrose and increases the risk of hypertriglyceridemia and
hyperglycemia
B. the drain phase takes 1-2 hours
C. dwell times can range from minutes to hours depending on the patients goals
D. during the inflow phase, a prescribed amount of solution is infused through a catheter by
gravity over ~10 minutes - Answers B
the drain phase takes 15-30 minutes
You are a clinical instructor and a student is asking about *continuous ambulatory peritoneal
dialysis*. Which of the following statements requires further teaching?
,A. "patients should have at least 4 exchanges a day"
B. "after draining dialysate, patients should wait at least 30 minutes before infusing a new bag"
C. "dwell times average about 4 hours"
D. "maintaining aseptic technique will help to prevent peritonitis" - Answers B
after dwell time (reaching equilibrium), the dialysate is drained from the peritoneal cavity and a
new bag is infused. dialysis fluid is always in the peritoneal cavity, so dialysis is continually
ongoing
You are a nurse working in the community. Which of the following statements by a patient about
their *automated peritoneal dialysis* requires further teaching?
A. "i should make sure to maintain aseptic technique to prevent peritonitis"
B. "i will be connected to the cycler during the night while I sleep"
C. "the fluid should be drained from my peritoneal cavity in the morning before i disconnect from
the machine"
D. "my cycler completes the fill, dwell, and drain phases" - Answers C
the patient disconnects from the machine in the morning and carries dialysate in the abdomen
during the day
Which of the following would *not* be a potential contraindication for peritoneal dialysis?
A. history of diverticulitis
B. severe COPD
C. low BMI
D. chronic back pain - Answers C
severe obesity with abdominal wall and fat deposits would be a potential complication. anything
that wouldn't tolerate extra pressure in the abdomen (i.e., 2L of fluid) would be a potential
, contraindication
Which of the following are complications of peritoneal dialysis? Select all that apply.
A. bleeding
B. leakage at catheter site
C. peritonitis
D. portal hypertension - Answers A, B and C
*must maintain aseptic technique to prevent peritonitis* and can occur as a result from
contamination or from progression of an exit-site or tunnel infection, or from bacteria crossing
from intestine into peritoneal cavity.
You are out working in the community. A patient is complaining of fever, nausea/vomiting,
abdominal pain, and rebound tenderness. Which of the following are they likely experiencing?
A. transfusion reaction
B. peritonitis
C. infection at site of PD catheter
D. vaccine reaction - Answers B
Your patient who undergoes peritoneal dialysis says that his drainage is cloudy. What should
you do? Select all that apply.
A. send to lab for culture and sensitivity
B. increase frequency of exchanges
C. discontinue dialysis temporarily
D. treat with PO or IV antibiotics - Answers A and D
Your patient who undergoes peritoneal dialysis has an exit site infection. A student is
shadowing you for the day. Which of the following statements made by the student requires
further teaching?