A nurse is caring for a client who is receiving peritoneal dialysis and notes a decrease in the dialysate flow rate. Which of the following actions should the nurse take? (Select all that apply.)

Nursing care for a client receiving Peritoneal dialysis involves ensuring adequate inflow and outflow of dialysate through the peritoneal catheter. A decrease in dialysate flow rate may indicate catheter obstruction, poor positioning, constipation, or fibrin blockage. Maintaining patency and proper drainage is essential for effective waste removal and fluid balance. Nursing interventions focus on troubleshooting mechanical causes, monitoring output, and optimizing patient positioning. Rationale: A. Raising the drainage bag above the level of the client’s abdomen is incorrect because gravity is required for proper drainage during peritoneal dialysis. Elevating the bag can impede outflow and worsen fluid retention in the peritoneal cavity. The drainage bag should always be positioned below the level of the abdomen to promote effective effluent flow. B. Elevating the client to the high-Fowler’s position is not the most effective intervention for improving dialysate flow. Although slight positional changes may assist drainage, high-Fowler’s positioning is not routinely required and may not resolve catheter-related issues. More effective strategies include repositioning the client or checking for mechanical obstruction. C. Measuring the amount of dialysate outflow is appropriate because it helps determine whether the client is retaining fluid or experiencing inadequate drainage. Comparing inflow and outflow volumes allows the nurse to assess dialysis efficiency and identify potential complications such as catheter blockage or peritoneal membrane issues. Accurate measurement is essential for ongoing evaluation of treatment effectiveness. D. Monitoring the access site for drainage is important because leakage around the catheter site may indicate improper catheter function or dislodgement. It also helps identify signs of infection or peritoneal fluid escape. Early detection of abnormal drainage supports timely intervention and prevents further complications. E. Repositioning the client onto the other side is appropriate because changes in body position can help dislodge catheter obstructions and improve dialysate flow. Turning the client may allow trapped fluid or fibrin to move and restore gravity-assisted drainage. This is a common first-line nursing intervention when flow rate decreases during peritoneal dialysis.