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 B

Explanation

Choice a reason: Administering intravenous fluids during the procedure is not a common practice in hemodialysis. The primary goal of hemodialysis is to remove excess fluids and waste products from the blood. Administering IV fluids during the procedure would counteract this goal and could potentially lead to fluid overload. Any fluid administration should be carefully monitored and controlled based on the client's specific needs and medical condition.
Choice b reason: Assessing blood pressure before and after the procedure is essential in managing clients undergoing hemodialysis. Hemodialysis can cause significant fluctuations in blood pressure due to the removal of fluid and changes in blood volume. Monitoring blood pressure helps in detecting and managing hypotension or hypertension, ensuring the client's hemodynamic stability throughout the procedure. It also helps in adjusting the dialysis prescription and fluid removal rate to optimize the treatment.
Choice c reason: Encouraging the client to consume a high-sodium diet is not advisable for clients undergoing hemodialysis. High sodium intake can lead to fluid retention and hypertension, which are detrimental to clients with kidney disease. Instead, clients are often advised to follow a low-sodium diet to help control blood pressure and reduce the risk of fluid overload.
Choice d reason: Monitoring electrolyte levels weekly is important but not always adequate. Clients on hemodialysis may require more frequent monitoring of electrolytes, especially potassium, phosphorus, and calcium, to ensure that levels remain within a safe range. Frequent monitoring helps in adjusting the dialysis treatment and dietary recommendations to prevent complications related to electrolyte imbalances.

A. Simvastatin B. Pantoprazole C. Valsartan D. Metformin

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.

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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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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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