A client with chronic kidney disease on peritoneal dialysis has redness, tenderness, and drainage around the catheter site on the abdominal wall. Which complication is the nurse most concerned about preventing?

A client with chronic kidney disease on peritoneal dialysis has redness, tenderness, and drainage around the catheter site on the abdominal wall. Which complication is the nurse most concerned about preventing?

• A. Atelectasis
• B. Exit site infection
• C. Peritonitis
• D. Outflow obstruction.

Answer: (C)

In peritoneal dialysis, an infection at the catheter exit site is a warning sign because it can travel along the catheter into the peritoneal cavity. The most important complication to prevent is peritonitis, a serious infection of the peritoneum that can develop if bacteria ascend from the exit site. Peritonitis can cause abdominal pain, cloudy dialysis effluent, fever, and can threaten the integrity of the catheter and the patient’s ability to continue PD. So, redness, tenderness, and drainage at the exit site indicate an exit-site infection, and the nurse’s priority is to prevent progression to peritonitis through prompt assessment, strict aseptic technique during exchanges, appropriate treatment of the exit-site infection, and early recognition and treatment of any signs of peritonitis. Atelectasis and outflow obstruction are not indicated by this presentation and are less immediately relevant concerns.

In peritoneal dialysis, an infection at the catheter exit site is a warning sign because it can travel along the catheter into the peritoneal cavity. The most important complication to prevent is peritonitis, a serious infection of the peritoneum that can develop if bacteria ascend from the exit site. Peritonitis can cause abdominal pain, cloudy dialysis effluent, fever, and can threaten the integrity of the catheter and the patient’s ability to continue PD. So, redness, tenderness, and drainage at the exit site indicate an exit-site infection, and the nurse’s priority is to prevent progression to peritonitis through prompt assessment, strict aseptic technique during exchanges, appropriate treatment of the exit-site infection, and early recognition and treatment of any signs of peritonitis. Atelectasis and outflow obstruction are not indicated by this presentation and are less immediately relevant concerns.