6 Peritoneal Dialysis Nursing Care Plans


When your kidneys are healthy, they clean your blood. If your kidneys fail, you will need a life-saving treatment, this is when dialysis takes place. Dialysis is the process of removing fluid and waste products from the body, a function usually performed by the kidneys, through artificial means. Two types of dialysis: hemodialysis and peritoneal dialysis. Peritoneal dialysis accomplishes the removal of waste and excess fluid by using the abdominal lining, called the peritoneal membrane, as a filter a membrane across which fluids and dissolved substances (electrolytes, urea, glucose, albumin, and other small molecules) are exchanged from the blood.

Peritoneal dialysis is similar in principle to hemodialysis. Both of these forms of renal replacement therapy depend upon the passive movement of water and dissolved substances (solutes) across a semipermeable membrane. This process is called diffusion. The direction of movement of solute is determined by the relative concentration on each side of the membrane so that a substance goes from the side of greater to lesser concentration.

The peritoneum serves as the semipermeable membrane permitting transfer of nitrogenous wastes/toxins and fluid from the blood into a dialysate solution. Peritoneal dialysis is sometimes preferred because it uses a simpler technique and provides more gradual physiological changes than hemodialysis.

The manual single-bag method is usually done as an inpatient procedure with short dwell times of only 30–60 minutes and is repeated until desired effects are achieved. The most commonly used type of peritoneal dialysis is continuous ambulatory peritoneal dialysis (CAPD), which permits the patient to manage the procedure at home with bag and gravity flow, using a prolonged dwell time at night and a total of 3–5 cycles daily, 7 days a week. No machinery is required.

Continuous cycling peritoneal dialysis (CCPD) mechanically cycles shorter dwell times during night (3–6 cycles) with one 8-hr dwell time during daylight hours, increasing the patient’s independence. An automated machine is required to infuse and drain dialysate at preset intervals.

Nursing Care Plans

The nursing care plan goals for patients undergoing peritoneal dialysis include maintaining fluid and electrolyte balance, monitoring vital signs and weight changes, assessing for signs of infection, and ensuring proper placement and functioning of the catheter. Another important goal is to educate the patient on the self-care techniques needed for peritoneal dialysis and to provide emotional support throughout the treatment process.


This post contains six (6) nursing care plans (NCP) and nursing diagnosis for peritoneal dialysis:

  1. Risk for Deficient Fluid Volume
  2. Risk for Ineffective Breathing Pattern
  3. Risk for Infection
  4. Acute Pain
  5. Risk for Trauma
  6. Risk for Excess Fluid Volume

Risk for Deficient Fluid Volume

One of the potential risks associated with peritoneal dialysis is deficient fluid volume. This can occur if too much fluid is removed during the dialysis process, leading to dehydration and electrolyte imbalances.

Nursing Diagnosis

  • Risk for Deficient Fluid Volume

Risk Factors

  • Use of hypertonic dialysate with excessive removal of fluid from circulating volume

Desired Outcomes

  • The patient will achieve desired alteration in fluid volume and weight with BP and electrolyte levels within acceptable range.
  • The patient will experience no symptoms of dehydration.

Nursing Assessment and Rationale

1. Measure and record intake and output, including all body fluids, such as wound drainage, nasogastric output, and diarrhea.
Provides information about the status of patient’s loss or gain at the end of each exchange.

2. Maintain record of inflow and outflow volumes and individual and cumulative fluid balance.
Provides information about the status of patient’s loss or gain at the end of each exchange.

3. Assess hb and hct and replace blood components, as indicated.
This is important in view of under-dialysis in patients of normal or near normal hematocrit and suggests the need for modification of dialysis prescription in such situations.

Nursing Interventions and Rationales

1. Adhere to schedule for draining dialysate from abdomen.
Prolonged dwell times, especially when 4.5% glucose solution is used, may cause excessive fluid loss.

2. Weigh when the abdomen is empty, following initial 6–10 runs, then as indicated
Detects rate of fluid removal by comparison with baseline body weight.

3. Monitor vital signs. watch and report any signs of pericarditis (pleuritic chest pain, tachycardia, pericardial friction, rub), inadequate renal perfusion (hypotension), and acidosis.
Patients with end-stage renal disease (ESRD) may develop pericardial disease.

4. Monitor BP (lying and sitting) and pulse. Note level of jugular pulsation
Decreased BP, postural hypotension, and tachycardia are early signs of hypovolemia

5. Note reports of dizziness, nausea, and increased thirst.
May indicate hypovolemia and hyperosmolar syndrome.

6. Inspect mucous membranes, evaluate skin turgor, peripheral pulses, capillary refill
Dry mucous membranes, poor skin turgor and diminished pulses and capillary refill are indicators of dehydration and need for increased intake and changes in strength of dialysate.

7. Monitor laboratory studies as indicated: Serum sodium and glucose levels;
Hypertonic solutions may cause hypernatremia by removing more water than sodium. In addition, dextrose may be absorbed from the dialysate, thereby elevating serum glucose.

8. Maintain proper electrolyte balance. Serum potassium levels. Watch for symptoms of hyperkalemia (malaise, anorexia, paresthesia, or muscle weakness) and electrocardiogram changes (tall peaked T waves, widening QRS segment, and disappearing P waves), and report them immediately.
Although a small percentage of patients are chronically hypokalemic, hyperkalemia is by far the most common abnormality in dialysis patients.

9. Assess patient frequently, especially during emergency treatment to lower potassium levels. If the patient receives hypertonic glucose and insulin infusions, monitor potassium levels. If you give sodium polystyrene sulfonate rectally, make sure the patient doesn’t retain it and becomes constipated.
To prevent bowel perforation.

10. Maintain nutritional status. Provide a high-calorie, low-protein, low-sodium, and low-potassium diet, with vitamin supplements.
To balance nutritional intake.

11. Aggressively restore fluid volume after major surgery or trauma.
Dialysis disequilibrium syndrome is a frequent complication of renal replacement therapy and seems to be related to changes in fluid balance.


Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues, and on electrolytes and acid-base balance.

NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

Other care plans and nursing diagnoses related to reproductive and urinary system disorders:


Matt Vera, a registered nurse since 2009, leverages his experiences as a former student struggling with complex nursing topics to help aspiring nurses as a full-time writer and editor for Nurseslabs, simplifying the learning process, breaking down complicated subjects, and finding innovative ways to assist students in reaching their full potential as future healthcare providers.

1 thought on “6 Peritoneal Dialysis Nursing Care Plans”

  1. Really helpful information thank you very much was struggling to get the appropriate interventions for my nursing diagnosis in renal failure and nurses slabs gave them at once


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