A nurse is caring for a client with acute kidney injury (AKI). The client's urine output is significantly reduced, and laboratory tests show elevated levels of blood urea nitrogen (BUN) and creatinine. Which of the following is the primary indication for initiating dialysis in this client?

A. Correct. Using the arm with the AV fistula for blood pressure measurements can compress the vascular access and compromise blood flow. It is important to avoid using the fistula arm for blood pressure measurements and venipuncture.

B. Incorrect. The AV fistula should not be used for intravenous catheter insertion to prevent potential damage and infection to the access site.

C. Incorrect. Self-cannulation of the AV graft is typically performed by healthcare professionals, and clients should not attempt to self-cannulate their vascular access.

D. Incorrect. If an AV fistula starts bleeding, the client should not apply pressure to the site. Instead, they should immediately elevate the arm and apply pressure to the bleeding site with a clean cloth or bandage while seeking medical attention.

QUESTIONS

A) This statement is incorrect. Infection is not a rare complication of peritoneal dialysis. It is a common risk that requires proactive measures to prevent.

B) This statement is incorrect. While infections can occur and may be treatable with antibiotics, it is essential to focus on prevention and maintaining aseptic technique.

C) This statement is incorrect. Taking antibiotics regularly to prevent infection is not the standard practice for clients on peritoneal dialysis. Antibiotics are typically prescribed to treat infections when they occur, not as a preventive measure.

D) This statement is accurate. Infection is a significant risk for clients on peritoneal dialysis due to the direct access to the peritoneal cavity through the catheter. Strict aseptic technique is crucial to prevent infections.