The nurse is checking the patency of a new right arm arteriovenous fistula. What action does the nurse use to do this? Select all that apply
auscultate the right brachial pulse
palpate for thrill over the right arm fistula
measure the blood pressure in the right arm
auscultate the right radial pulse
auscultate bruit over the right arm fistula
palpate the right radial pulse
Correct Answer : B,E
A. Auscultating the brachial pulse is not typically used to assess the patency of an arteriovenous fistula.
B. A thrill is a vibration felt over an arteriovenous fistula or graft and indicates proper blood flow. Palpation for thrill is a standard method to assess fistula patency.
C. Blood pressure measurement does not directly assess the patency of an arteriovenous fistula.
D. Auscultating the radial pulse is not typically used to assess the patency of an arteriovenous fistula.
E. A bruit is a swooshing sound heard over an arteriovenous fistula or graft and indicates turbulent blood flow. Auscultating for bruit is another method to assess fistula patency.
F. Palpate the right radial pulse: Palpating the radial pulse is not typically used to assess the patency of an arteriovenous fistula.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. A negative waveform indicates a downward deflection from the baseline on an ECG tracing, which may correspond to electrical activity such as depolarization or repolarization of cardiac chambers.
B. An isoelectric line represents the baseline on an ECG tracing when there is no net electrical activity occurring in the heart. It appears flat and represents a period of electrical silence.
C. A downward deflection on an ECG tracing refers to a negative waveform, as mentioned above.
D. A positive waveform on an ECG tracing indicates an upward deflection from the baseline, representing electrical activity such as depolarization or repolarization.
Correct Answer is B
Explanation
A. In the oliguric phase of acute kidney injury, fluid intake may need to be restricted rather than encouraged to prevent fluid overload.
B. Hourly intake and output monitoring is crucial for managing fluid balance and assessing the progression of kidney injury. Close monitoring can help prevent fluid overload, which is a risk due to the reduced urine output. It also aids in the timely adjustment of fluid administration and the detection of any changes in the client's condition that may necessitate intervention.
C. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are contraindicated in acute kidney injury as they can further impair renal function.
D. In the oliguric phase, protein intake may need to be restricted to reduce the workload on the kidneys and minimize azotemia. A high-protein diet can increase the burden on already compromised kidneys due to the increased production of urea, a byproduct of protein metabolism that requires excretion by the kidneys.
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