A nurse is developing a plan of care for a client who is to begin receiving peritoneal dialysis. Which intervention would the nurse implement during the dialysate exchange?

A. Hang the drain bag on an IV pole prior to infusing dialysate: The dialysate drain bag should be positioned lower than the client’s abdomen to allow for passive drainage by gravity, not on an IV pole above the client, which could interfere with proper outflow and increase the risk of complications. B. Maintain the client in a left lateral position during exchanges: Positioning during peritoneal dialysis is usually supine or semi-Fowler’s to facilitate inflow and outflow of dialysate. Lateral positioning is not standard practice and may hinder proper fluid distribution within the peritoneal cavity. C. Monitor vital signs every two hours during the procedure: Frequent vital signs monitoring is important for overall assessment but continuous monitoring is not typically required for stable clients during a standard peritoneal dialysis exchange unless complications such as hypotension or infection are suspected. D. Warm the dialysate solution prior to instilling into the client: Warming the dialysate to body temperature prevents discomfort, abdominal cramping, and vasoconstriction. Cold dialysate can cause pain, reduce peritoneal blood flow, and decrease the efficiency of solute exchange, making this the most important intervention during the exchange.