NORCET 2 -2021 (Shift-2)
Medical & Surgical Nursing
Medium
A patient plan for peritoneal dialysis, which of the following is a priority nursing action?
Appeared in: NORCET 2 -2021 (Shift-2)
Explanation
- Warming the dialysate solution to body temperature (around 37°C) is a critical preparatory step.
- This action prevents abdominal cramping and discomfort for the patient upon infusion of the fluid.
- Warming the solution also causes vasodilation of the peritoneal blood vessels, which enhances the clearance of waste products, making the dialysis more effective.
- It is considered a standard of care to ensure both patient comfort and optimal therapeutic outcomes.
Why Other Options Were Wrong
- Option A: Positioning is a corrective action, not a preparatory priority. It is used to troubleshoot problems with dialysate drainage (outflow), not as a standard step before starting.
- Option C: A Foley catheter is for urinary drainage and is not required for peritoneal dialysis. Inserting one would be an unnecessary invasive procedure, increasing the risk of a urinary tract infection.
- Option D: This assessment is used to check the patency of an arteriovenous (AV) fistula or graft, which is the vascular access for hemodialysis. It is completely irrelevant to peritoneal dialysis.
Related Visual
Clinical Relevance
- Nursing practice connection: Safe nursing care depends on performing Priority Nursing Actions for Peritoneal Dialysis in the correct sequence, documenting the action clearly, and monitoring for the expected response.
- Patient comfort and safety are paramount in peritoneal dialysis. Warming the dialysate directly impacts patient comfort and the effectiveness of the therapy.
- A critical nursing skill is differentiating the care requirements for peritoneal dialysis versus hemodialysis. Confusing the two can lead to significant errors, such as performing an irrelevant assessment.
- The highest risk associated with peritoneal dialysis is peritonitis. Therefore, maintaining strict aseptic (sterile) technique during all connections and disconnections is the most crucial ongoing nursing action to prevent this life-threatening complication.
How to Approach the Question
- First, identify the core subject of the question: 'peritoneal dialysis'.
- Next, identify the key instruction: 'priority nursing action'. This means you must find the most important action to perform before the procedure.
- Evaluate each option in the context of peritoneal dialysis.
- Option D mentions 'bruit and thrill'. Recall that this assessment is for hemodialysis access (AV fistula/graft). Eliminate it as it applies to the wrong procedure.
- Option C suggests a 'Foley's catheter'. This is for urinary drainage and is not a standard part of peritoneal dialysis. Eliminate it.
- Compare the remaining options. 'Positioning' (Option A) is a troubleshooting step for poor drainage, not a preparatory priority. 'Warming the solution' (Option B) is a standard preparatory step to ensure patient comfort and effectiveness. Therefore, warming the solution is the highest priority among the choices.
Concept Tested & Keywords
- Concept Tested: Priority Nursing Actions for Peritoneal Dialysis
- Stem keywords: peritoneal dialysis, priority nursing action
- Lead-in keywords: priority
Question ID
QR-KUrV9MLlAxMk4wW8HhS
Reference Book
E6 Nursing Fundamentals Taylor p. 610-612
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 783-785
Practise the full NORCET 2 -2021 (Shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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