Final answer:
When drainage of dialysate halts prematurely during peritoneal dialysis, the nurse should instruct the client to turn from side to side. This action can reposition a kinked or displaced catheter and promote the flow of the dialysate.
The correct answer is option 2.
Step-by-step explanation:
When a nurse observes that the drainage of the dialysate from the peritoneal cavity has ceased before the required volume has returned during peritoneal dialysis, it is often recommended that the client perform certain maneuvers to facilitate the drainage. One common suggestion is for the client to turn from side to side. This action can help in repositioning the catheter within the peritoneal cavity, which may have become kinked or displaced, and can promote the flow of dialysate.
Peritoneal dialysis is a procedure that allows individuals with kidney failure to have waste products and excess fluid removed from their blood. This process involves the infusion of dialysate into the peritoneal cavity, where it comes into contact with blood vessels. Through osmosis and diffusion, waste products such as urea are transferred from the blood to the dialysate. Unlike hemodialysis, which directly filters blood outside the body through a dialysis machine, peritoneal dialysis takes advantage of the natural membrane lining the abdomen as a filter.
A nurse, under the direct supervision of a registered nurse, will ensure that the dialysis process runs smoothly by monitoring vital signs, preparing solutions, equipment, and responding to any complications that may arise during the treatment. If the dialysate doesn't drain as expected, it is critical to resolve the issue to prevent incomplete treatment or other complications. Therefore, the nurse may instruct the patient to turn from side to side to improve drainage because this movement can shift the position of the catheter to an optimal location for fluid flow.
Rotating the catheter periodically may be done during the placement of the catheter, but it is not typically recommended as a solution for drainage issues during an actual dialysis session due to the risks of dislodgement or peritonitis. Instead, deep breathing and coughing or drinking a glass of water might be suggested to increase intra-abdominal pressure, but turning from side to side is the most frequently recommended first action.