Page 1848 - Saunders Comprehensive Review For NCLEX-RN

extend beyond the PHCP’s
prescription, because this increases the
risk for hyperglycemia.
i. Initiate outflow; turn the client from
side to side if the outflow is slow to
start.
j. Monitor outflow, which should be a
continuous stream after the clamp is
opened.
k. Monitor outflow for color and clarity.
l. Monitor intake and output accurately; if
outflow is less than inflow, the
difference is equal to the amount
absorbed or retained by the client
during dialysis and should be counted
as intake.
m. An outflow greater than inflow as well
as the appearance of frank blood or
cloudiness in the outflow should be
reported to the PHCP.
F. Types of PD

1. Continuous ambulatory peritoneal dialysis

(CAPD)
a. Closely resembles renal function
because it is a continuous process
b. Does not require a machine for the
procedure
c. Promotes client independence
d. The client performs self-dialysis 24
hours a day, 7 days a week.
e. Four dialysis cycles are usually
administered in a 24-hour period,
including an overnight 8-hour dwell
time.
f. Dialysate, 1.5 to 2 L, is instilled into the
abdomen 4 times daily and allowed to
dwell as prescribed (bags are weighed
to determine output); the catheter is
clamped and the bag is rolled up
during dwell time.
g. After dwell, the bag is placed lower
than the insertion site and the clamp is
opened so that fluid drains out by
gravity flow.
h. After fluid is drained, the bag is
changed, new dialysate is instilled into
the abdomen, and the process

1848