A nurse is providing peritoneal dialysis to a child and observes there is minimal dialysate outflow at the end of the outflow time. Which of the following actions should the nurse take?
Increase the dwell time during the next dialysis infusion.
Instruct the child to change position.
Increase oral fluid intake.
Assess for a bruit at the site of the peritoneal catheter.
The Correct Answer is B
Choice A rationale
Increasing the dwell time during the next dialysis infusion is not appropriate. The issue is with the outflow, not the dwell time. Increasing the dwell time could exacerbate the problem.
Choice B rationale
Instructing the child to change position is correct. Changing position can help facilitate the drainage of dialysate by allowing gravity to assist in the outflow process.
Choice C rationale
Increasing oral fluid intake is not relevant to the issue of minimal dialysate outflow. The problem lies with the mechanical process of dialysis, not fluid intake.
Choice D rationale
Assessing for a bruit at the site of the peritoneal catheter is not directly related to resolving minimal dialysate outflow. A bruit indicates blood flow through a vascular access, not the peritoneal catheter.
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Correct Answer is A
Explanation
Choice A rationale
The primary purpose of obtaining consent is to ensure that the patient understands the risks, benefits, and alternatives of the proposed treatment. This process respects patient autonomy and allows them to make informed decisions about their care.
Choice B rationale
While family input can be important, obtaining consent is primarily about ensuring the patient themselves understands and agrees to the treatment. It is not about obtaining permission from the family.
Choice C rationale
Protecting the nurse from legal liability is not the main purpose of obtaining consent. The focus is on patient understanding and autonomy.
Choice D rationale
Consent is about involving the patient in their care decisions, not bypassing their input. It ensures that the patient is fully informed and agrees to the treatment plan.
Correct Answer is C
Explanation
Choice A rationale
Holding urine for extended periods may indicate urinary retention, which is not the desired outcome of treatment for enuresis. The goal of enuresis treatment is to help the child develop better bladder control and responsiveness to the need to urinate.
Choice B rationale
Kegel exercises primarily target pelvic floor muscles and may not directly address the underlying causes of enuresis. While Kegel exercises can be beneficial for strengthening pelvic muscles, they are not typically the primary focus of conditioning therapy for enuresis.
Choice C rationale
Waking to urinate in response to the alarm indicates improved bladder control and responsiveness to conditioning therapy for enuresis. This statement suggests that the child is becoming more aware of the need to urinate and is responding appropriately to the alarm, which is a positive sign of treatment effectiveness.
Choice D rationale
Drinking less may not necessarily indicate treatment effectiveness and could lead to dehydration. It is important for children to maintain adequate hydration, and reducing fluid intake is not a recommended strategy for managing enuresis.