A client on hemodialysis has a history of arteriovenous (AV) fistula creation. Which of the following assessments should the nurse perform to ensure proper functioning of the AV fistula?
Palpate for a thrill or vibration over the AV fistula site.
Auscultate for bruits over the radial artery.
Check for distal pulses in the lower extremities.
Assess for swelling and tenderness in the neck.
The Correct Answer is A
A) This statement is accurate. Palpating for a thrill or vibration over the AV fistula site is a critical assessment to ensure proper functioning. A thrill indicates adequate blood flow through the fistula, which is essential for effective hemodialysis.
B) This statement is incorrect. Auscultating for bruits over the radial artery is not related to the AV fistula assessment. The bruit is the sound of blood flow in the fistula, which is best assessed directly over the fistula site.
C) This statement is incorrect. Checking for distal pulses in the lower extremities is not related to the assessment of an AV fistula. The AV fistula is typically created in the upper extremity.
D) This statement is incorrect. Assessing for swelling and tenderness in the neck is not related to the AV fistula assessment. Swelling and tenderness may be related to other issues but are not specific to AV fistula functioning.
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Related Questions
Correct Answer is C
Explanation
A) This statement is incorrect. Serum calcium levels are not directly related to ESA therapy for anemia management. ESA therapy focuses on increasing red blood cell production.
B) This statement is incorrect. Blood urea nitrogen (BUN) levels are indicators of kidney function and may be monitored for other reasons in a client on peritoneal dialysis. However, they are not directly related to ESA therapy for anemia management.
C) This statement is accurate. During ESA therapy, the nurse should closely monitor the client's hemoglobin and hematocrit levels. ESAs stimulate the production of red blood cells and can increase hemoglobin and hematocrit levels. Regular monitoring is essential to prevent anemia or excessive increases in these values.
D) This statement is incorrect. Serum potassium levels may be monitored for a client on peritoneal dialysis due to the potential for electrolyte imbalances, but they are not the primary concern during ESA therapy for anemia management.
Correct Answer is A
Explanation
A) This statement is incorrect. Increasing the dialysis session duration would not address the client's muscle cramps and may lead to further fluid and electrolyte imbalances.
B) Muscle cramps during hemodialysis can be caused by the cooling effect of the dialysate solution. Increasing the temperature of the dialysate can help alleviate the cramps.
C) This statement is incorrect. Decreasing the dialysate solution flow rate may not directly address the muscle cramps and may not be indicated unless there are other clinical indications to do so.
D) This statement is incorrect. Administering an anticoagulant medication is not relevant to address muscle cramps. Muscle cramps during hemodialysis are often caused by the cooling effect of the dialysate solution. Increasing the temperature of the dialysate can help alleviate the cramps.
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