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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?

 

A.

Increase the dwell time during the next dialysis infusion.

B.

Instruct the child to change position.

C.

Increase oral fluid intake.

D.

Assess for a bruit at the site of the peritoneal catheter.

Answer and Explanation

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

Bradypnea, or slow breathing, is a common and serious side effect of morphine, especially in children. It requires immediate attention.

Choice B rationale

Morphine does not typically affect wound healing. This is more associated with corticosteroids.

Choice C rationale

Morphine can cause hypotension, not hypertension.

Choice D rationale

Stevens-Johnson syndrome is a rare but severe reaction to medications, including some antibiotics and anticonvulsants, but not commonly associated with morphine.

Correct Answer is B

Explanation

Choice A rationale

Reinforcing the dressing may be necessary, but controlling bleeding is the immediate priority. Applying pressure just above the insertion site is the first step to control bleeding and prevent further blood loss.

Choice B rationale

Applying pressure just above the insertion site is the first step to control bleeding and prevent further blood loss. This action helps to stop the bleeding and stabilize the patient.

Choice C rationale

Obtaining vital signs is important, but it can wait momentarily until the bleeding is under control. The immediate priority is to stop the bleeding.

Choice D rationale

Monitoring the pulse distal to the insertion site is important, but controlling bleeding takes precedence. Once the bleeding is controlled, the nurse can then monitor the pulse

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