The nurse notes the presence of a cloudy dialysate return for a client in acute renal failure receiving peritoneal dialysis. Which of the following actions does the nurse initiate after notifying the physician?
1. Culture the dialysate return
2. Chart the cloudy dialysate
3. Measure abdominal girth
4. Slow dialysate instillation
1. Culture the dialysate return.
Rationale:
The return should be clear. The presence of cloudy drainage might indicate peritonitis, and the nurse should culture the return in order to help identify the presence and type of organism that could be causing the infection. Charting the cloudy dialysate and nursing actions taken would be necessary, but is not the next-priority action. Measurement of abdominal girth is performed prior to the dialysis procedure, and although increased girth could indicate peritonitis, culturing the return is more important. The instillation part of the procedure is completed prior to the collection of the dialysate return, and the rate of the instillation has no relationship to the development of an infection.
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