A client performing peritoneal dialysis reports new abdominal pain, and the drained dialysate is cloudy. Which instruction should the nurse provide?
1Increase the dextrose concentration in the next bag to remove additional fluid
2Warm the next dialysate bag in a microwave before continuing treatment
3Continue the usual exchanges and inspect the drainage again tomorrow
4Notify the dialysis team promptly and keep the drainage bag for evaluation✓ Correct answer
Explanation
Abdominal pain with cloudy peritoneal dialysis effluent suggests peritonitis, a serious infection requiring immediate evaluation and treatment. The client should notify the dialysis team promptly and preserve the drainage bag so the effluent can be assessed according to the treatment plan.
Quick answer Report cloudy effluent and abdominal pain immediately. These are warning signs of peritoneal dialysis-associated peritonitis.
Why this is correct Peritoneal dialysis uses an indwelling catheter that can introduce bacteria into the abdominal cavity. Inflammation fills the effluent with cells and debris, making it cloudy, while abdominal pain reflects peritoneal irritation; delayed treatment can lead to sepsis or catheter loss.
Easy analogy or mental picture Normally clear dialysate is like a clean window into the exchange. New cloudiness is an alarm that something is collecting inside, but appearance alone does not identify the organism and laboratory evaluation is still needed.
Memory hook Cloudy outflow plus abdominal pain means suspect peritonitis and call the dialysis team now.
NCLEX decision rule For peritoneal dialysis, treat cloudy used solution, abdominal pain, fever, or catheter-site infection signs as urgent. Preserve useful evidence and obtain prompt dialysis-team guidance rather than modifying the prescription independently.
Why the other choices are wrong Changing dextrose concentration does not treat infection. Microwaving dialysate can create dangerous hot spots, and waiting until tomorrow delays evaluation of possible peritonitis.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
NIDDK: Peritoneal DialysisNational Institute of Diabetes and Digestive and Kidney Diseases