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A client with diabetes receiving peritoneal dialysis experiences chills and abdominal discomfort. The nurse assesses the client's abdomen by pressing firmly into the abdominal wall. The client experiences pain when the nurse quickly withdraws the hand. The client's most recent blood glucose level is r210 mg/dL (11.65 mmol/L). What is the priority action by the nurse?

User Sarcastyx
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Final answer:

The nurse should immediately notify a healthcare provider about the signs indicative of an infection, potentially peritonitis. While managing the high blood glucose is important, the immediate symptoms suggesting infection are the critical issue needing prompt attention and potential emergency care.

Step-by-step explanation:

The priority action by the nurse should be to notify the physician or a healthcare provider immediately about the symptoms, as they could indicate an infection or possible peritonitis, a common complication in patients undergoing peritoneal dialysis. Considering the abdominal pain with rebound tenderness (pain upon quick withdrawal of the pressing hand), along with chills, it is vital to assess for peritonitis which could be an emergency situation. The blood glucose level of 210 mg/dL also needs to be managed, but the signs of infection are the immediate concern.

Diabetes mellitus is known to affect kidney function, as the kidneys filter glucose from the blood. When blood glucose levels rise above the renal threshold, glucosuria occurs. Persistent hyperglycemia can lead to serious complications such as damage to the kidneys and other organs. With peritoneal dialysis, the risk of infection is heightened and symptoms such as abdominal pain and chills should be promptly addressed. Diabetes management involves careful monitoring of blood glucose levels to prevent both hyperglycemia and hypoglycemia, the latter of which can occur during insulin therapy if doses are too high. Awareness of the symptoms and prompt intervention are crucial in providing effective care for diabetics undergoing peritoneal dialysis.

User GregK
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