Question

A client who is undergoing peritoneal dialysis calls the nurse at the renal unit and reports the presence of severe abdominal pain and diarrhea. The client also informs the nurse that the peritoneal dialysis returns are brown-tinged in color. Which would the nurse suspect?

1.Infection
2.An intact catheter
3.Bowel perforation
4.Bladder perforation

Answer 1

Based on the symptoms reported, the nurse would suspect a bowel perforation causing peritonitis, which is a serious condition requiring immediate medical evaluation and treatment.

Step-by-step explanation:

Likely, the nurse would suspect bowl perforation based on the symptoms of severe abdominal pain, diarrhea, and brown-tinged peritoneal dialysis returns reported by the client. Brown-tinged returns may indicate the presence of fecal material in the peritoneal cavity, which can occur when there is a perforation in the gastrointestinal tract. This can lead to a life-threatening condition known as peritonitis, an inflammation of the peritoneum that is associated with bacterial infections from conditions like appendicitis, colonic diverticulitis, and pelvic inflammatory disease. The patient's symptoms and the brown discoloration of the peritoneal dialysis return suggest that intestinal contents have potentially entered the peritoneal cavity, causing chemical peritonitis and increased risk of infection. Immediate medical evaluation is critical to assess for perforation, infection, and initiate appropriate management, which may include emergency surgery and antibiotic therapy to address the underlying issue and prevent complications like sepsis.