Page 1849 - Saunders Comprehensive Review For NCLEX-RN

continues.
i. Between exchanges, the catheter is
clamped.
2. Automated peritoneal dialysis (Box 54-8)
a. Automated dialysis requires a
peritoneal cycling machine.
b. Automated dialysis can be done as
intermittent peritoneal dialysis,
continuous cycling peritoneal dialysis,
or nightly peritoneal dialysis.
c. The exchanges are automated instead of
manual.
X. Complications of Peritoneal Dialysis

Infection is a concern with PD; sites of infection are either the catheter insertion site or the

peritoneum, causing peritonitis.
A. Peritonitis

1. Monitor for signs and symptoms of peritonitis: Fever,
cloudy outflow, rebound abdominal tenderness,
abdominal pain, general malaise, nausea, and
vomiting.
2. Cloudy or opaque outflow is an early sign of
peritonitis.
3. If peritonitis is suspected, obtain a sample for culture
and sensitivity of the outflow to determine the
infective organism.
4. Antibiotics may be added to the dialysate.
5. Avoid infections by maintaining meticulous sterile
technique when connecting and disconnecting PD
solution bags and when caring for the catheter
insertion site.
6. Prevent the catheter insertion site dressing from
becoming wet during care of the client or the dialysis
procedure; change the dressing if wet or soiled.
7. Follow institutional procedure for connecting and
disconnecting PD solution bags, which may include
scrubbing the connection sites with an antiseptic
solution.
B. Abdominal pain
1. Peritoneal irritation during inflow commonly causes
abdominal cramping and discomfort during the first
few exchanges; the pain usually disappears after 1 to
2 weeks of dialysis treatments.

2. Warm the dialysate before administration,

1849