Question about peritoneal dialysis and what the nurse should do

Hellllllo Nurse, BSN, RN · Dec 5, 2006

The pt's fluid status is determined by the pt's assessment- s/s, not the numbers. But, by the numbers you have written, are you saying the pt absorbed fluid the first two exchanges?

buterflycf · Dec 5, 2006

yes, my teacher gave this to us and said for us to think about what it means. She wants to know what the nurse would be thinking about when she saw this. Isnt it normal that the patient retain some fluid in the beginning? Thanks for being so quick

Hellllllo Nurse, BSN, RN · Dec 5, 2006

In my experience, pts do not normally retain fluid in the beginning. If a pt's blood glucose is very high and a glucose dianeal solution is being used, sometimes the pt's blood osmolarity is greater than that of the dianeal, causing fluid to be absorbed into the pt's vasculatur, rather than removed.

So, it's important to know your pt's blood glucose levels and keep them under control. Also, the pt may need a stronger dianeal to pull more fluid. How do you think this would be determined?

buterflycf · Dec 5, 2006

would it be based on weight? Thanks!

Hellllllo Nurse, BSN, RN · Dec 14, 2006

Weight is part of it- also V/S. symptoms and assessment.

If a pt is heavy, hypertensive, has any edema, the nurse would use a stronger dianeal to pull more fluid off.

Is the pt is light, has poor turgor, skin is dry, low bp, nausea, dizzy when standing up- the nurse would use a weaker dianeal and encourage the pt to take in a little more po fluids or have IV fluids increased.