Which intervention does the nurse utilize post-operatively to assess the patency of the arteriovenous fistula?

Assess the fistula with a large bore needle

Auscultate the fistula site for a bruit.

Measure the blood pressure in the affected arm

Assess the rate and quality of the radial pulse on the affected arm

Answer and Explanation

The Correct Answer is B

A. Assess the fistula with a large bore needle: Large bore needles are used during dialysis sessions, not for routine assessment. Inappropriate needling can damage the fistula.

B. Auscultate the fistula site for a bruit: A functional AV fistula should have a palpable thrill (vibration) and an audible bruit (whooshing sound) when auscultated with a stethoscope. These findings confirm adequate blood flow and patency.

C. Measure the blood pressure in the affected arm: Blood pressure measurements should never be taken on the fistula arm to prevent compression and potential fistula failure.

D. Assess the rate and quality of the radial pulse on the affected arm: The radial pulse does not accurately assess AV fistula patency; the focus should be on the thrill and bruit.

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Correct Answer is D

Explanation

A. Nocturia: Excessive nighttime urination, not decreased urine output.

B. Enuresis: Involuntary urination, commonly bedwetting in children.

C. Anuria: Severe lack of urine output (< 100 mL/24 hrs), which is worse than oliguria.

D. Oliguria: Oliguria is defined as urine output < 400 mL/24 hours. 250 mL in 24 hours qualifies as oliguria.

A. Fluid will be pushed in the interstitial spaces B. Fluid will be pulled out of the cells and into the blood stream. C. Fluid will be pushed out of the blood stream into the extravascular spaces. D. Fluid will be pulled out of the bloodstream into the cells

Correct Answer is B

Explanation

A. Fluid will be pushed into the interstitial spaces. Hypertonic solutions draw water into the bloodstream, not into tissues.

B. Fluid will be pulled out of the cells and into the bloodstream: Hypertonic solutions (e.g., 3% NaCl, D10W) have a higher osmolarity than blood plasma. This pulls fluid from cells into the intravascular space, causing cell shrinkage and increasing blood volume.

C. Fluid will be pushed out of the bloodstream into extravascular spaces. This describes a hypotonic solution’s effect.

D. Fluid will be pulled out of the bloodstream into the cells. This describes an isotonic or hypotonic effect.

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Which intervention does the nurse utilize post-operatively to assess the patency of the arteriovenous fistula?

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