A client on hemodialysis has a history of arteriovenous (AV) fistula creation. Which of the following assessments should the nurse perform to ensure proper functioning of the AV fistula?

Palpate for a thrill or vibration over the AV fistula site.

Auscultate for bruits over the radial artery.

Check for distal pulses in the lower extremities.

Assess for swelling and tenderness in the neck.

Answer and Explanation

The Correct Answer is A

A) This statement is accurate. Palpating for a thrill or vibration over the AV fistula site is a critical assessment to ensure proper functioning. A thrill indicates adequate blood flow through the fistula, which is essential for effective hemodialysis.

B) This statement is incorrect. Auscultating for bruits over the radial artery is not related to the AV fistula assessment. The bruit is the sound of blood flow in the fistula, which is best assessed directly over the fistula site.

C) This statement is incorrect. Checking for distal pulses in the lower extremities is not related to the assessment of an AV fistula. The AV fistula is typically created in the upper extremity.

D) This statement is incorrect. Assessing for swelling and tenderness in the neck is not related to the AV fistula assessment. Swelling and tenderness may be related to other issues but are not specific to AV fistula functioning.

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Correct Answer is B

Explanation

A. Incorrect. Limiting fluid intake is important for some clients with renal issues, but clients on dialysis typically need to maintain adequate hydration due to fluid removal during the procedure.

B. Correct. Clients on dialysis often need to consume plenty of fluids to compensate for the fluid removal that occurs during dialysis treatment, preventing dehydration and maintaining hemodynamic stability.

C. Incorrect. Increasing salt intake is not recommended for clients on dialysis, as it can contribute to fluid retention and worsen hypertension.

D. Incorrect. Limiting fluid intake only on the day of dialysis treatment is not sufficient to maintain overall hydration and may lead to imbalances and complications between dialysis sessions.

A. Increased fluid removal B. Decreased urine output C. Hydration overload D. Hypotension

Correct Answer is A

Explanation

A) This statement is accurate. Hypertonic dialysate has a higher concentration of glucose, which results in increased fluid removal from the client's peritoneal cavity. This type of dialysate is often used for more effective ultrafiltration.

B) This statement is incorrect. Infusing hypertonic dialysate does not result in decreased urine output. Peritoneal dialysis is a process of exchanging fluids and waste products through the peritoneal membrane, but it does not directly affect urine production.

C) This statement is incorrect. Infusing hypertonic dialysate would not lead to hydration overload, as it causes fluid to be removed from the body.

D) This statement is incorrect. Hypertonic dialysate would not cause hypotension. In fact, it may lead to a decrease in blood pressure due to fluid removal, but it would not be considered a primary cause of hypotension.

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A client on hemodialysis has a history of arteriovenous (AV) fistula creation. Which of the following assessments should the nurse perform to ensure proper functioning of the AV fistula?

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