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 D

Explanation

Choice a reason: Simvastatin, a statin medication used to control high cholesterol, does not typically interact with IV contrast dye. There is no need to withhold simvastatin before radiological studies involving contrast dye. The primary concern with simvastatin is monitoring for potential side effects, such as muscle pain and liver function, but these are not directly related to contrast dye use.
Choice b reason: Pantoprazole, a proton pump inhibitor used to reduce stomach acid, does not have known interactions with IV contrast dye. It can be safely continued before, during, and after radiological studies involving contrast. The main considerations with pantoprazole are related to its effect on stomach acid and potential side effects like headaches or gastrointestinal issues.
Choice c reason: Valsartan, an angiotensin II receptor blocker used to manage hypertension, does not interact with IV contrast dye. There is no need to withhold valsartan before undergoing radiological studies with contrast. Valsartan is primarily concerned with managing blood pressure and may have side effects such as dizziness or increased potassium levels, but these are not influenced by contrast dye.
Choice d reason: Metformin, an oral hypoglycemic agent used to manage type 2 diabetes, should be withheld prior to radiological studies with IV contrast dye. There is a risk of lactic acidosis, a rare but serious complication, when metformin is combined with contrast dye. To reduce this risk, metformin should be withheld for at least 48 hours before and after the procedure, and renal function should be monitored closely. This precaution helps ensure the safety of clients undergoing radiological studies with contrast dye.

A. Furosemide 80 mg PO daily B. Ketoprofen 75 mg PO three times a day C. Acyclovir 400 mg PO twice daily D. Ranitidine 150 mg PO twice daily

Correct Answer is A

Explanation

Choice a reason: Furosemide is a loop diuretic, which works by increasing the excretion of sodium and water in the urine. However, it also increases the excretion of potassium, leading to a significant risk of hypokalemia (low potassium levels). Patients on furosemide should have their potassium levels monitored regularly and may require potassium supplements to prevent hypokalemia.
Choice b reason: Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain relief and inflammation reduction. It does not typically affect potassium levels or cause hypokalemia. NSAIDs can affect kidney function, but they are not associated with causing low potassium levels.
Choice c reason: Acyclovir is an antiviral medication used to treat infections caused by herpes viruses. It does not have an impact on potassium levels and is not known to cause hypokalemia. Its primary side effects are related to kidney function and gastrointestinal issues, but it does not significantly alter electrolyte levels.
Choice d reason: Ranitidine is a histamine H2-receptor antagonist used to reduce stomach acid production. It is primarily used for treating conditions like acid reflux and peptic ulcers. Ranitidine does not affect potassium levels and is not associated with causing hypokalemia. Its side effects are generally mild and gastrointestinal in nature.

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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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