A client on peritoneal dialysis receives 1000 mL of dialysate. At the end of the exchange, the nurse records a negative fluid balance of 100 mL. How much fluid drained out?

1. A

   900 mL

2. B

   1000 mL

3. C

   1100 mL

4. D

   1200 mL

Appeared in: NORCET-11 Mains

Explanation

• In peritoneal dialysis, 'fluid balance' refers to the difference between the volume of dialysate drained (outflow) and the volume instilled (inflow).
• A 'negative fluid balance' of 100 mL in this context means that 100 mL of excess fluid was successfully removed from the patient's body (this is also called ultrafiltration).
• The calculation is: Total Drained Fluid = Instilled Fluid + Removed Fluid.
• Therefore, 1000 mL (instilled) + 100 mL (removed) = 1100 mL (drained).

Why Other Options Were Wrong

• Option A: This amount would be correct if the patient absorbed 100 mL of fluid, indicating fluid retention.
• Option B: This amount indicates a neutral fluid balance, where the volume in equals the volume out, meaning no fluid was removed.
• Option D: This amount corresponds to a fluid removal of 200 mL, not the 100 mL stated in the question.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Fluid balance calculation in peritoneal dialysis to guide bedside assessment, documentation, and the next nursing action.
• Accurate monitoring and documentation of inflow and outflow volumes in peritoneal dialysis are critical nursing responsibilities to manage the patient's fluid status and prevent complications like fluid overload or dehydration.
• The nurse must also assess the characteristics of the drained fluid (effluent). Clear, pale yellow fluid is normal, while cloudy fluid is a key sign of peritonitis, a serious infection requiring immediate intervention.
• What if? If the effluent was cloudy and the patient complained of abdominal pain, the nurse's priority would be to notify the physician immediately, as these are hallmark signs of peritonitis. The nurse would also prepare to collect a sample of the effluent for culture.

How to Approach the Question

• First, identify the given values: Inflow (1000 mL) and the recorded fluid balance ('negative fluid balance of 100 mL').
• Second, interpret the key term. In the context of dialysis, a 'negative fluid balance' signifies the net amount of fluid removed from the patient.
• Third, set up the equation: Total Outflow = Inflow + Fluid Removed.
• Fourth, substitute the values into the equation: Outflow = 1000 mL + 100 mL.
• Finally, calculate the result (1100 mL) and select the corresponding option.

Concept Tested & Keywords

• Concept Tested: Fluid balance calculation in peritoneal dialysis.
• Stem keywords: peritoneal dialysis, 1000 mL dialysate, negative fluid balance, 100 mL
• Lead-in keywords: How much
• Clinical cues: The term 'negative fluid balance' in the context of dialysis refers to net fluid removal from the patient, which can be counterintuitive to standard I/O charting.
• Negative lead-in flag: false

Question ID

Qicq8NK_G_dmkVneHrWhBf

Copy ID

Reference Book

E6 Medicine Harrison 22e Part 2 p. 304-306

E6 Nutrition Kumud Khanna 2e p. 378-380