A nurse is assessing a client's arteriovenous fistula prior to hemodialysis, but does not hear a bruit or feel a thrill. Pulses distal to the fistula are not palpable, and the capillary refill is slow. Which of the following actions is the nurse's priority?
Proceed with hemodialysis.
Notify the provider immediately.
Raise the arm above the level of the patient's heart.
Apply warm packs to the fistula site and reassess.
The Correct Answer is B
A. This is incorrect and potentially dangerous. A non-functioning fistula will not provide adequate blood flow for dialysis and can lead to complications.
B. This is the correct action. The nurse should immediately inform the healthcare provider about the compromised fistula. The provider can order further diagnostic tests or interventions as needed.
C. This might improve blood flow temporarily, but it is not a definitive solution and does not address the underlying issue.
D. While warm packs can sometimes improve circulation, it is unlikely to resolve the serious issues found in this case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Calcium gluconate is used to treat or prevent calcium deficiencies and to manage conditions related to calcium imbalances, such as hypocalcemia. It is not typically used to prevent struvite stones.
B. Antibiotics are the most appropriate choice for preventing the recurrence of struvite stones. Since struvite stones are associated with urinary tract infections caused by urease-producing bacteria, antibiotic therapy is aimed at eliminating these infections. By treating or preventing UTIs, the conditions that lead to struvite stone formation are addressed, reducing the likelihood of recurrence.
C. Tamsulosin is an alpha-blocker used to relax the muscles in the prostate and bladder neck to improve urine flow in conditions like benign prostatic hyperplasia (BPH). It is not specifically used for preventing struvite stones.
D. Phosphate binders are used to reduce phosphate levels in the blood, which is important in managing conditions such as chronic kidney disease (CKD) where phosphate levels can be elevated.
Correct Answer is ["4"]
Explanation
To administer a total daily dose of 200 mg of imipramine divided equally every 12 hours, the nurse would need to give two doses of 100 mg each. Since the available tablets are 25 mg each, four tablets would be required to make up a single dose of 100 mg.
Therefore, the nurse should administer four tablets every 12 hours to meet the prescribed daily dosage.
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