The nurse is teaching a patient about performing peritoneal dialysis (PD) at home. In order to identify the earliest manifestation of peritonitis, what does the nurse instruct the patient to do?

Rationale: A. While abdominal pain may occur with peritonitis, it is a later sign that appears after infection has already developed. The goal is to detect peritonitis at its earliest stage to prevent complications. B. A fever may occur as peritonitis progresses, but it is not an early indicator. Relying solely on temperature changes may delay recognition of the infection. C. General malaise is a nonspecific symptom that can occur with many conditions. It does not provide an early or definitive indication of peritonitis. D. The earliest and most reliable sign of peritonitis in clients receiving peritoneal dialysis is cloudy or opaque dialysate effluent. The cloudiness results from the presence of white blood cells and bacteria in the dialysate, signaling infection in the peritoneal cavity. Prompt reporting and treatment can prevent severe complications.