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 C
Explanation
Choice A rationale
Enuresis (bedwetting) is not an immediate concern in a child with sickle cell anemia and does not require urgent reporting to the provider.
Choice B rationale
Kyphosis (curvature of the spine) is not an immediate concern in a child with sickle cell anemia and does not require urgent reporting to the provider.
Choice C rationale
Facial twitching is a priority finding as it may indicate a neurological complication or electrolyte imbalance, which requires immediate attention and intervention.
Choice D rationale
Constipation is not an immediate concern in a child with sickle cell anemia and does not require urgent reporting to the provider.
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.