A nurse is teaching a client and his partner about performing peritoneal dialysis at home. When discussing peritonitis, which of the following manifestations should the nurse identify as the earliest indication of this complication?

Rationale: A. Increased heart rate: Increased heart rate can be a general sign of infection or discomfort, but it is not the earliest indication of peritonitis in peritoneal dialysis. Other symptoms like cloudy effluent typically present earlier. B. Generalized abdominal pain: While abdominal pain can be a sign of peritonitis, it typically appears after other signs like cloudy effluent, so it is not usually the earliest indicator. C. Cloudy effluent: Cloudy effluent is the earliest and most indicative sign of peritonitis in peritoneal dialysis. This is due to the presence of white blood cells and bacteria in the peritoneal fluid, which is a hallmark of infection. D. Fever: Fever is a later symptom of peritonitis. It typically occurs after the infection has progressed and is not the earliest sign to monitor for in the context of peritoneal dialysis.