The nurse is caring for a client with End Stage Renal Disease has a mature Arteriovenous Fistula. Which of the following interventions would the nurse include in the client's plan of care?
Select All that Apply

Avoid drawing blood from the affected extremity

Auscultate the fistula for the sound of a bruit

Palpate the site to identify the presence of a thrill

Irrigate the fistula with saline to maintain patency

Keep the fistula clamped until ready to perform dialysis

Answer and Explanation

Correct Answer : A,B,C

A. Avoid drawing blood from the affected extremity: Blood draws, IVs, and BP measurements should never be done on the fistula arm to prevent damage and thrombosis.

B. Auscultate the fistula for the sound of a bruit: A bruit (whooshing sound) confirms blood flow through the fistula, indicating patency.

C. Palpate the site to identify the presence of a thrill: A thrill (vibration) should be felt over the fistula. Absence may indicate clotting or failure.

D. Irrigate the fistula with saline to maintain patency: A fistula is never irrigated. Only dialysis staff should access it.

E. Keep the fistula clamped until ready to perform dialysis: AV fistulas are not clamped. Clamping could obstruct blood flow.

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Correct Answer is A

Explanation

A. Obstruction of the bile duct: Biliary cirrhosis (now called primary or secondary biliary cholangitis) can occur due to prolonged bile duct obstruction, leading to liver damage and cirrhosis.

B. Hepatitis C: Hepatitis C can cause cirrhosis, but it is not a direct cause of biliary cirrhosis. Instead, it leads to post-viral cirrhosis.

C. Hepatotoxic medications: Certain medications (e.g., acetaminophen overdose) can cause liver damage, but they do not specifically cause biliary cirrhosis.

D. Excessive alcohol consumption: Alcohol abuse can cause alcoholic cirrhosis, but not biliary cirrhosis.

A. "You can donate blood as long as your symptoms have resolved.”" B. " It is safe to consume alcohol in moderation.” C. "You should inform your sexual partners about your diagnosis." D. "You do not need to follow up with your healthcare provider once you feel better."

Correct Answer is C

Explanation

A. "You can donate blood as long as your symptoms have resolved.": Clients with a history of hepatitis B can never donate blood, even if symptoms have resolved, due to the risk of latent infection and transmission.

B. "It is safe to consume alcohol in moderation.": Alcohol should be avoided because it worsens liver inflammation and damage in hepatitis B.

C. "You should inform your sexual partners about your diagnosis.": Hepatitis B (HBV) is a bloodborne virus transmitted through sexual contact, blood, and bodily fluids. Clients should inform sexual partners and practice safe sex to prevent transmission.

D. "You do not need to follow up with your healthcare provider once you feel better.": Follow-up is essential to monitor liver function, prevent complications, and check for chronic hepatitis B, which may lead to cirrhosis or liver cancer.

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The nurse is caring for a client with End Stage Renal Disease has a mature Arteriovenous Fistula. Which of the following interventions would the nurse include in the client's plan of care? Select All that Apply

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The nurse is caring for a client with End Stage Renal Disease has a mature Arteriovenous Fistula. Which of the following interventions would the nurse include in the client's plan of care?
Select All that Apply