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 B
Explanation
Choice A rationale
This statement is nontherapeutic because it shifts the focus away from the patient and onto the nurse’s personal experience. It can minimize the patient’s feelings and is not helpful in providing support.
Choice B rationale
Asking the patient to demonstrate how they give themselves insulin is a therapeutic communication technique. It shows interest in the patient’s self-care practices and provides an opportunity for the nurse to offer guidance and support.
Choice C rationale
This statement is nontherapeutic because it offers false reassurance. It does not address the patient’s concerns or provide any real support.
Choice D rationale
This statement is also nontherapeutic because it offers false reassurance and does not address the patient’s specific concerns or needs.
Correct Answer is C
Explanation
Choice A rationale
Repeating childhood immunizations once in remission is not necessary. Children with HIV should follow the standard immunization schedule with some modifications based on their immune status.
Choice B rationale
The risk of transmission does not significantly decrease after just 2 weeks on zidovudine. Continuous adherence to antiretroviral therapy is essential for reducing viral load and transmission risk.
Choice C rationale
Ensuring the child is tested for tuberculosis every year is important. Children with HIV are at higher risk for TB due to their compromised immune systems.
Choice D rationale
Doubling medications for 6 months is not a standard practice and can lead to toxicity and adverse effects. Medication dosages should be carefully managed by healthcare providers.