Question

a client experiencing end - stage kidney disease has an arteriovenous (av) fistula placed surgically for hemodialysis. which action is most appropriate for the nurse to document in the plan for care of the av fistula?
answer options
1 palpate the bruit of the av fistula weekly to assess for thrombosis.
2 use the av fistula site for blood draws to prevent increased pain of multiple blood draws.
3 take the blood pressure readings in the extremity with the av fistula to get a more accurate reading.
4 teach the client to avoid carrying heavy objects that would compress the av fistula and cause thrombosis.
rationale, strategy, tip

Explanation:

1. Option 1: Bruits are auscultated, not palpated, to assess for thrombosis in an AV fistula, so this is incorrect.
2. Option 2: The AV fistula site should not be used for blood draws as it can damage the fistula, so this is incorrect.
3. Option 3: Blood pressure readings should not be taken on the extremity with the AV fistula as it can cause thrombosis, so this is incorrect.
4. Option 4: Teaching the client to avoid carrying heavy objects that compress the AV fistula is appropriate to prevent thrombosis, as compression can disrupt blood flow and lead to clotting.

Answer:

1. Teach the client to avoid carrying heavy objects that would compress the AV fistula and cause thrombosis.