The nurse is reviewing a client’s record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the nurse most likely would expect to note which finding?

Choice A reason: Palpation of a thrill, a vibrating sensation, indicates blood flow and patency in an arteriovenous fistula. This aligns with hemodialysis access assessment, making it the correct finding the nurse would use to confirm the fistula is patent.

Choice B reason: A radial pulse in the wrist is normal but doesn’t confirm fistula patency, which requires a thrill. Palpation of a thrill is specific, making this incorrect, as it’s not a direct indicator of fistula function in hemodialysis preparation.

Choice C reason: Enlarged vessels may suggest fistula development but don’t confirm active flow. A thrill indicates patency, making this incorrect, as it’s less specific than the nurse’s assessment of a palpable thrill over the fistula site.

Choice D reason: Capillary refill less than 3 seconds assesses distal perfusion, not fistula patency. Palpation of a thrill is the standard, making this incorrect, as it’s unrelated to the nurse’s evaluation of the arteriovenous fistula for hemodialysis.

Choice A reason: Elevated creatinine is a hallmark of chronic kidney disease, reflecting reduced glomerular filtration rate. This aligns with renal function assessment, making it the correct finding the nurse would expect in a client with chronic kidney disease based on laboratory results.

Choice B reason: Decreased hemoglobin may occur in chronic kidney disease due to anemia, but it’s less specific than elevated creatinine, a direct renal marker. This is incorrect, as it’s secondary to the nurse’s primary expectation of creatinine elevation in kidney disease.

Choice C reason: Decreased red blood cell count accompanies anemia in kidney disease but is less direct than creatinine, which measures kidney function. This is incorrect, as it’s not the primary finding the nurse would expect compared to elevated creatinine levels.

Choice D reason: Increased white blood cells in urine suggest infection, not a universal finding in chronic kidney disease. Elevated creatinine is more consistent, making this incorrect, as it’s not the nurse’s primary expected lab result in kidney disease assessment.