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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Incorrect. Warming the dialysate fluid to body temperature before instilling it into the peritoneal cavity is a standard procedure in continuous ambulatory peritoneal dialysis (CAPD. .
B. Correct. Performing the exchanges in a clean, dry environment free from pets is crucial to prevent contamination and reduce the risk of infection during CAPD.
C. Incorrect. Using tap water to cleanse the catheter insertion site before the exchange is not recommended. The catheter exit site should be cleaned with an appropriate antiseptic solution as instructed by the healthcare provider.
D. Incorrect. While daily dressing changes are important, using sterile technique for catheter dressing changes may not be necessary, as the dressing does not directly contact the peritoneal cavity during CAPD exchanges.
Correct Answer is B
Explanation
A. Increase the dialysis session duration: Extending the session may help reduce fluid shifts over time, but it is not an immediate intervention to relieve acute muscle cramps during dialysis.
B. Increase the dialysate solution temperature: Warming the dialysate can improve muscle perfusion and reduce the incidence of cramping during dialysis. It helps minimize vasoconstriction and discomfort.
C. Decrease the dialysate solution flow rate: This is not typically used to treat muscle cramps. Flow rate adjustments affect solute clearance and may not alleviate cramping.
D. Administer an anticoagulant medication: Anticoagulants are used to prevent clotting in the dialysis circuit and do not treat or prevent muscle cramps.
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