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
Toddlers are typically more emotionally labile, meaning they experience rapid and intense emotional changes. This is a normal part of their development as they learn to navigate their emotions.
Choice B rationale
Frequent negative responses, such as saying “no” often, are common in toddlers. This behavior is part of their development as they assert their independence and test boundaries.
Choice C rationale
Toddlers are generally more resistant to routines as they seek to assert their independence and explore their environment. They may resist following set routines as a way of expressing their autonomy.
Choice D rationale
Increased dependency is not typical toddler behavior. Toddlers are usually striving for more independence and autonomy, even though they still rely on caregivers for support.
Correct Answer is D
Explanation
Choice A rationale
Placing the infant in a recumbent position during feeding is not recommended as it can increase the risk of aspiration. The infant should be held in an upright or semi-upright position to facilitate safe swallowing and digestion.
Choice B rationale
Allowing the infant 45 minutes for each feeding can be too long and may lead to fatigue and decreased feeding efficiency. It is generally recommended to limit feeding sessions to 20-30 minutes to ensure the infant gets adequate nutrition without becoming overly tired.
Choice C rationale
Allowing the infant to self-soothe by crying prior to feeding is not advisable, especially for infants with heart failure. Crying can increase the infant’s metabolic demands and oxygen consumption, which can be detrimental to their condition.
Choice D rationale
Implementing a 3-hour feeding schedule helps ensure that the infant receives regular and consistent nutrition. This schedule can help manage the infant’s energy levels and prevent fatigue, which is important for infants with heart failure.