👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: PD · home dialysis · belly dialysis · CAPD · abdominal dialysis
💡
Use this quick-reference guide to spot, treat, and prevent Peritoneal Dialysis on the NCLEX. Keep it handy during review and on exam day!
🩺
📒 The 1-minute cheat sheet
📌 Mech
dialysate into peritoneal cavity
fill → dwell → drain cycle
slower, done at home, daily
✅ Do
STRICT sterile technique
warm dialysate before instilling
outflow > inflow expected
🚩 Report
CLOUDY effluent = peritonitis
fever, abd pain, rebound
outflow < inflow → check kink
📌 Fix
slow drain → reposition, ambulate
watch hyperglycemia (glucose absorb)
📚 Peritoneal Dialysis — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Peritoneal dialysis uses the patient's own peritoneal membrane as the filter. Dialysate is instilled into the abdominal cavity via a catheter, dwells while waste and fluid diffuse across the membrane, then is drained out. It can be done at home and offers more independence but carries a high risk of peritonitis. It is an alternative to hemodialysis for ESRD.
🔑
Key points
Understand these first
The process is fill, dwell, and drain; the dwell time allows exchange of wastes and fluid.
Peritonitis is the most common and serious complication, signaled by CLOUDY drain effluent.
Drained dialysate (outflow) should be clear and pale yellow; cloudy fluid indicates infection.
Warming the dialysate before instillation promotes comfort and dilates peritoneal vessels for better exchange.
Outflow that is less than inflow (fluid retention) may indicate a kinked catheter, constipation, or fibrin clot.
Higher dextrose concentration dialysate pulls off more fluid but raises blood glucose.
✅
Nursing priorities
What to do, in order
Use strict sterile technique with every exchange and catheter handling.
Assess the color of outflow each exchange; report cloudy effluent as a sign of peritonitis.
Track inflow versus outflow volumes and document; warm dialysate before instilling.
Reposition the patient, check for kinks/constipation if outflow is inadequate.
Monitor blood glucose because dialysate dextrose is absorbed.
🚩
Red flags — report now
Escalate immediately
Cloudy outflow, abdominal pain, fever, or rebound tenderness - signs of peritonitis; report immediately.
Never instill cold dialysate or use breaks in sterile technique.
Significant fluid retention (much less drained than instilled) with respiratory difficulty - escalate.
Bloody or brown effluent (beyond the first few exchanges) - report.
🧪
Labs & values
Numbers to know
Glucose: normal 70-110 mg/dL (monitor for elevation from dialysate)
Potassium and BUN/Creatinine: monitor effectiveness
WBC of effluent: elevated with peritonitis
🗣️
Patient teaching
What patients must know
Always wash hands and use sterile technique; wear a mask during exchanges.
Report cloudy fluid, abdominal pain, or fever immediately as signs of infection.
Keep the catheter exit site clean and dry, prevent constipation, and weigh daily.
❓ Peritoneal Dialysis: NCLEX FAQs
What are the priority nursing interventions for Peritoneal Dialysis?
Use strict sterile technique with every exchange and catheter handling. Assess the color of outflow each exchange; report cloudy effluent as a sign of peritonitis. Track inflow versus outflow volumes and document; warm dialysate before instilling. Reposition the patient, check for kinks/constipation if outflow is inadequate.
What are the warning signs of Peritoneal Dialysis a nurse must report?
Cloudy outflow, abdominal pain, fever, or rebound tenderness - signs of peritonitis; report immediately. Never instill cold dialysate or use breaks in sterile technique. Significant fluid retention (much less drained than instilled) with respiratory difficulty - escalate. Bloody or brown effluent (beyond the first few exchanges) - report.
What do I need to know about Peritoneal Dialysis for the NCLEX?
The process is fill, dwell, and drain; the dwell time allows exchange of wastes and fluid. Peritonitis is the most common and serious complication, signaled by CLOUDY drain effluent. Drained dialysate (outflow) should be clear and pale yellow; cloudy fluid indicates infection. Warming the dialysate before instillation promotes comfort and dilates peritoneal vessels for better exchange.
What patient teaching is important for Peritoneal Dialysis?
Always wash hands and use sterile technique; wear a mask during exchanges. Report cloudy fluid, abdominal pain, or fever immediately as signs of infection. Keep the catheter exit site clean and dry, prevent constipation, and weigh daily.
✨
Quick Tip
The process is fill, dwell, and drain; the dwell time allows exchange of wastes and fluid.