Answer: 2. Increase intake of legumes in the diet.
Rationale: Dietary instructions to the client with a uric acid type kidney stone include increasing legumes, green vegetables, and fruits (except prunes, grapes, cranberries, and citrus fruits) to increase the alkalinity of the urine. The client should also be instructed to decrease purine sources such as organ meats, gravies, red wines, goose, venison, and seafood.
Answer: 1. Nausea and vomiting
3. Abdominal tenderness
4. Cloudy peritoneal effluent
5. Oral temperature of 38° C
Rationale: Peritoneal dialysis is a treatment used in clients with ESKD as an alternative to hemodialysis. The procedure involves the instillation of dialysate fluid into the peritoneal cavity where excess body wastes, fluid, and electrolytes are removed through diffusion and osmosis across the semipermeable peritoneal membrane and peritoneal capillaries. A peritoneal catheter is surgically placed into the abdominal cavity and is used to instill and drain the dialysate fluid, known as effluent. Peritonitis, or infection of the peritoneal cavity, is a possible complication of peritoneal dialysis. The effluent becomes cloudy instead of the normal clear straw color, and the client has symptoms of abdominal tenderness and pain, nausea, vomiting, and fever. Thirty-eight degrees Celsius is an elevated temperature indicating fever, a sign of infection. Poor dialysate outflow is usually caused by constipation. Leakage of clear fluid at the exit site of the peritoneal catheter is more likely to occur in obese or diabetic clients. It occurs as the client physiologically adjusts to the instillation of 2 L of dialysate fluid into the abdominal cavity.