The nurse is checking patency of a new right arm AV fistula. What action does the nurse use to do this?

Measure blood pressure in the right arm

Palpate for thrill and auscultate bruit over the fistula

Auscultate the right arm brachial pulse

Auscultate and palpate the right radial pulse

Answer and Explanation

The Correct Answer is B

Choice a reason: Measuring blood pressure in the right arm is not the appropriate action for checking the patency of an AV fistula. In fact, blood pressure measurements should be avoided on the arm with the fistula to prevent damage and ensure its proper function. The pressure from the cuff can impair blood flow through the fistula and potentially cause complications.
Choice b reason: Palpating for a thrill and auscultating for a bruit over the fistula is the correct method for assessing its patency. A thrill is a palpable vibration over the fistula, indicating blood flow through the vessel. A bruit is a whooshing sound heard with a stethoscope, also indicating blood flow. Both signs confirm that the fistula is functioning properly.
Choice c reason: Auscultating the right arm brachial pulse is not specific to checking the patency of an AV fistula. The brachial pulse reflects blood flow in the brachial artery, not the fistula. While assessing peripheral pulses is important, it does not provide specific information about the fistula's patency.
Choice d reason: Auscultating and palpating the right radial pulse is not the method used to assess an AV fistula's patency. The radial pulse provides information about peripheral circulation, but it does not directly indicate the function of the fistula. Checking for a thrill and bruit over the fistula is the most accurate way to assess its patency.

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Correct Answer is A

Explanation

Choice a reason: Dehydration is a significant risk factor for the formation of renal calculi (kidney stones). When the body is dehydrated, urine becomes concentrated with minerals and salts, which can crystallize and form stones. Ensuring adequate hydration is crucial in preventing kidney stone formation, as it helps to dilute the urine and flush out potential stone-forming substances.
Choice b reason: Protein in the urine, or proteinuria, is not a direct cause of kidney stones. Proteinuria can indicate underlying kidney disease or damage but is not typically linked to the formation of kidney stones. Monitoring protein levels in the urine is important for overall kidney health, but it is not a primary factor in stone formation.
Choice c reason: Obesity is associated with an increased risk of kidney stones. Obesity can lead to changes in the body's metabolism and increase the excretion of certain substances, such as calcium and oxalate, which can contribute to stone formation. Maintaining a healthy weight through diet and exercise can help reduce the risk of developing kidney stones.
Choice d reason: Iron deficiency is not a known risk factor for the formation of kidney stones. While maintaining adequate iron levels is important for overall health, it does not have a direct impact on the formation of renal calculi. Other dietary and metabolic factors play a more significant role in stone development.

A. Maintain IV fluids and encourage oral fluids B. Promote assisted ambulation as tolerated C. Strain urinary output and observe for stones D. Administer prescribed narcotic medication

Correct Answer is C

Explanation

Choice a reason: Maintaining IV fluids and encouraging oral fluids is important for patients with renal colic to ensure hydration and facilitate the passage of kidney stones. However, it is not the most immediate action to take for managing the patient's current condition, which includes severe pain and hematuria.
Choice b reason: Promoting assisted ambulation as tolerated can help in the movement and passage of kidney stones. Nevertheless, it is not the priority action to take initially when the patient is experiencing severe pain and there is a need to identify the cause of the hematuria.
Choice c reason: Straining urinary output and observing for stones is the most appropriate initial action. This allows the nurse to collect any stones that pass, which can then be analyzed to determine their composition. Understanding the type of stone can help in planning further treatment and preventive measures. Identifying and collecting the stones is crucial for proper diagnosis and management of renal colic.
Choice d reason: Administering prescribed narcotic medication is essential for managing severe pain associated with renal colic. Pain management is a critical component of care. However, while it is necessary, it should be accompanied by straining the urine to detect any stones and understand the underlying cause of the symptoms.

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The nurse is checking patency of a new right arm AV fistula. What action does the nurse use to do this?

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