During peritoneal dialysis, which finding would be most concerning for a significant complication requiring medical attention?

• A. White blood cell count of 20,000/mm3
• B. Blood pressure 120/80
• C. Temperature 98.6 F
• D. Oxygen saturation 98%

Answer: (A)

In peritoneal dialysis, the most urgent concern is infection, especially peritonitis, which can quickly lead to sepsis if not treated promptly. A white blood cell count of 20,000/mm3 indicates a significant systemic inflammatory response, often due to infection. This level signals that something serious is happening and requires immediate medical evaluation, including assessment for peritoneal infection and potentially starting antibiotics after appropriate cultures are obtained.

Normal vital signs such as blood pressure, temperature, and oxygen saturation are reassuring and do not by themselves point to an acute, life-threatening complication at this moment. The marked leukocytosis stands out as the warning sign that warrants prompt attention and action.